Form I-589 - Fill, Edit Online, Download & Print - No Signup

Image 1

Page 1 of 12

9.

Mailing Address in the U.S.

(if different than the address in Item Number

8)

8.

Residence in the U.S.

(where you physically reside)

Telephone Number

Telephone Number

(

18.

Check the box, a through c, that applies:

START HERE - Type or print in black ink. See the instructions for information about eligibility and how to complete and file this

application.

There is no filing fee for this application.

Part A.I. Information About You

1.

Alien Registration Number(s) (A-Number)

(if any)

2.

U.S. Social Security Number

(if any)

4.

Complete Last Name

7.

What other names have you used

(include maiden name and aliases)?

Street Number and Name

City

12.

Date of Birth

(mm/dd/yyyy)

14.

Present Nationality

(Citizenship)

5.

First Name

6.

Middle Name

)

Apt. Number

State

Zip Code

Apt. Number

Street Number and Name

Zip Code

City

State

10.

Sex

Male

Female

11.

Marital Status:

Single

Married

Divorced

Widowed

13.

City and Country of Birth

15.

Nationality at Birth

16.

Race, Ethnic, or Tribal Group

17.

Religion

I have never been in Immigration Court proceedings.

I am

not

now in Immigration Court proceedings, but I have been in the past.

I am now in Immigration Court proceedings.

a.

c.

b.

19.

Complete 19 a through c.

a.

When did you last leave your country?

(mm/dd/yyyy)

b.

What is your current I-94 Number, if any?

c.

List each entry into the U.S. beginning with your most recent entry.

List date (mm/dd/yyyy), place, and your status for each entry.

(Attach additional sheets as needed.)

Date

Place

Status

Date

Place

Status

Date

Place

Status

20.

What country issued your last passport or travel

document?

21.

Passport Number

Travel Document Number

NOTE:

Check this box if you also want to apply for withholding of removal under the Convention Against Torture.

(

)

Date Status Expires

22.

Expiration Date

(mm/dd/yyyy)

In Care Of

(if applicable):

23.

What is your native language

(include dialect, if applicable)?

24.

Are you fluent in English?

Yes

No

25.

What other languages do you speak fluently?

3.

USCIS Online Account Number

(if any)

Form I-589 Edition 01/20/25

(

NOTE:

You must be residing in the United States to submit this form.

)

Application for Asylum and for

Withholding of Removal

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form I-589

OMB No. 1615-0067

Expires 09/30/2027

Page 2 of 12

12.

Sex

14.

Sex

24.

If in the U.S., is your spouse to be included in this application?

(Check the appropriate box.)

15.

Is this person in the U.S.?

1.

Alien Registration Number (A-Number)

(if any)

5.

Complete Last Name

9.

Date of Marriage

(mm/dd/yyyy)

12.

Nationality

(Citizenship)

16.

Place of last entry into the

U.S.

20.

What is your spouse's

current status?

2.

Passport/ID Card Number

(if any)

3.

Date of Birth

(mm/dd/yyyy)

4.

U.S.

Social Security Number

(if any)

6.

First Name

7.

Middle Name

8.

Other names used

(include

maiden name and aliases)

10.

Place of Marriage

11.

City and Country of Birth

13.

Race, Ethnic, or Tribal Group

Male

Female

No

(Specify location):

17.

Date of last entry into the

U.S.

(mm/dd/yyyy)

18.

I-94 Number

(if any)

19.

Status when last admitted

(Visa type, if any)

21.

What is the expiration date of his/her

authorized stay, if any?

(mm/dd/yyyy)

23.

If previously in the U.S., date of

previous arrival

(mm/dd/yyyy)

22.

Is your spouse in Immigration

Court proceedings?

Yes

No

Yes

No

Yes

(Complete Blocks 16 to 24.)

I am not married. (Skip to

Your Children

below.)

Your Children.

List

all

of your children, regardless of age, location, or marital status.

I have children.

Total number of children:

.

(

NOTE:

Use Form I-589 Supplement A or attach additional sheets of paper and documentation if you have more than four children.)

Your spouse

Part A.II. Information About Your Spouse and Children

13.

Is this child in the U.S. ?

5.

Complete Last Name

9.

City and Country of Birth

6.

First Name

7.

Middle Name

8.

Date of Birth

(mm/dd/yyyy)

10.

Nationality

(Citizenship)

11.

Race, Ethnic, or Tribal Group

14.

Place of last entry into the U.S.

15.

Date of last entry into the

U.S.

(mm/dd/yyyy)

16.

I-94 Number

(If any)

17.

Status when last admitted

(Visa type, if any)

18.

What is your child's current status?

19.

What is the expiration date of his/her

authorized stay, if any?

(mm/dd/yyyy)

20.

Is your child in Immigration Court proceedings?

21.

If in the U.S., is this child to be included in this application?

(Check the appropriate box.)

1.

Alien Registration Number

(A-Number)

(if any)

2.

Passport/ID Card Number

(if any)

3.

Marital Status

(Married, Single,

Divorced, Widowed)

4.

U.S. Social Security Number

(if any)

Male

Female

Yes

No

Yes

No

Yes

(Complete Blocks 14 to 21.)

No

(Specify location)

:

I do not have any children.

(Skip to Part A.III., Information about your background.)

Form I-589 Edition 01/20/25

For EOIR use only.

For

USCIS

use only.

Action:

Decision:

Asylum Officer ID No.:

Approval Date:

Denial Date:

Referral Date:

Interview Date:

Page 3 of 12

Part A.II. Information About Your Spouse and Children

(continued)

13.

Is this child in the U.S. ?

5.

Complete Last Name

9.

City and Country of Birth

6.

First Name

7.

Middle Name

8.

Date of Birth

(mm/dd/yyyy)

10.

Nationality

(Citizenship)

12.

Sex

14.

Place of last entry into the U.S.

15.

Date of last entry into the

U.S.

(mm/dd/yyyy)

16.

I-94 Number

(If any)

17.

Status when last admitted

(Visa type, if any)

18.

What is your child's current status?

19.

What is the expiration date of his/her

authorized stay, if any?

(mm/dd/yyyy)

20.

Is your child in Immigration Court proceedings?

21.

If in the U.S., is this child to be included in this application?

(Check the appropriate box.)

Yes

No

Yes

No

1.

Alien Registration Number (A-Number)

(if any)

2.

Passport/ID Card Number

(if any)

3.

Marital Status

(Married, Single,

Divorced, Widowed)

4.

U.S. Social Security Number

(if any)

Male

Female

13.

Is this child in the U.S. ?

5.

Complete Last Name

9.

City and Country of Birth

6.

First Name

7.

Middle Name

8.

Date of Birth

(mm/dd/yyyy)

10.

Nationality

(Citizenship)

11.

Race, Ethnic, or Tribal Group

12.

Sex

14.

Place of last entry into the U.S.

15.

Date of last entry into the

U.S.

(mm/dd/yyyy)

16.

I-94 Number

(If any)

17.

Status when last admitted

(Visa type, if any)

18.

What is your child's current status?

19.

What is the expiration date of his/her

authorized stay, if any?

(mm/dd/yyyy)

20.

Is your child in Immigration Court proceedings?

21.

If in the U.S., is this child to be included in this application?

(Check the appropriate box.)

1.

Alien Registration Number (A-Number)

(if any)

2.

Passport/ID Card Number

(if any)

3.

Marital Status

(Married, Single,

Divorced, Widowed)

4.

U.S. Social Security Number

(if any)

Male

Female

Yes

No

Yes

No

13.

Is this child in the U.S. ?

5.

Complete Last Name

9.

City and Country of Birth

6.

First Name

7.

Middle Name

8.

Date of Birth

(mm/dd/yyyy)

10.

Nationality

(Citizenship)

11.

Race, Ethnic, or Tribal Group

12.

Sex

14.

Place of last entry into the U.S.

15.

Date of last entry into the

U.S.

(mm/dd/yyyy)

16.

I-94 Number

(If any)

17.

Status when last admitted

(Visa type, if any)

18.

What is your child's current status?

19.

What is the expiration date of his/her

authorized stay, if any?

(mm/dd/yyyy)

20.

Is your child in Immigration Court proceedings?

21.

If in the U.S., is this child to be included in this application?

(Check the appropriate box.)

1.

Alien Registration Number (A-Number)

(if any)

2.

Passport/ID Card Number

(if any)

3.

Marital Status

(Married, Single,

Divorced, Widowed)

4.

U.S. Social Security Number

(if any)

Male

Female

Yes

No

Yes

No

Yes

(Complete Blocks 14 to 21.)

No

(Specify location)

:

Yes

(Complete Blocks 14 to 21.)

No

(Specify location)

:

Yes

(Complete Blocks 14 to 21.)

No

(Specify location)

:

11.

Race, Ethnic, or Tribal Group

Form I-589 Edition 01/20/25

Page 4 of 12

Part A.III. Information About Your Background

1.

List your last address where you lived before coming to the United States. If this is not the country where you fear persecution, also list the last

address in the country where you fear persecution.

(List Address, City/Town, Department, Province, or State and Country.)

(

NOTE:

Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)

Number and Street

(Provide if available)

City/Town

Department, Province, or State

Country

Dates

From

(Mo/Yr)

To

(Mo/Yr)

2.

Provide the following information about your residences during the past 5 years. List your present address first.

(

NOTE:

Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)

Number and Street

City/Town

Department, Province, or State

Country

Dates

From

(Mo/Yr)

To

(Mo/Yr)

3.

Provide the following information about your education, beginning with the most

recent school that you attended.

(

NOTE:

Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)

Name of School

Type of School

Location

(Address)

Attended

From

(Mo/Yr)

To

(Mo/Yr)

4.

Provide the following information about your employment during the past 5 years. List your present employment first.

(

NOTE:

Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)

Name and Address of Employer

Your Occupation

Dates

From

(Mo/Yr)

To

(Mo/Yr)

5.

Provide the following information about your parents and siblings (brothers and sisters). Check the box if the person is deceased.

(

NOTE

:

Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)

Full Name

Mother

Father

Sibling

City/Town and Country of Birth

Current Location

Deceased

Deceased

Deceased

Sibling

Deceased

Sibling

Deceased

Sibling

Deceased

Form I-589 Edition 01/20/25

Page 5 of 12

1.

Why are you applying for asylum or withholding of removal under section 241(b)(3) of the INA, or for withholding of removal under the

Convention Against Torture? Check the appropriate box(es) below and then provide detailed answers to questions A and B below.

Religion

Nationality

Political opinion

Membership in a particular social group

Torture Convention

A.

Have you, your family, or close friends or colleagues ever experienced harm or mistreatment or threats in the past by anyone?

Yes

If "Yes," explain in detail:

1.

What happened;

2.

When the harm or mistreatment or threats occurred;

3.

Who caused the harm or mistreatment or threats; and

4.

Why you believe the harm or mistreatment or threats occurred.

B.

Do you fear harm or mistreatment if you return to your home country?

Yes

If "Yes," explain in detail:

1.

What harm or mistreatment you fear;

2.

Who you believe would harm or mistreat you; and

3.

Why you believe you would or could be harmed or mistreated.

Part B. Information About Your Application

(

NOTE:

Use Form I-589 Supplement B, or attach additional sheets of paper as needed to complete your responses to the questions contained in

Part B.)

When answering the following questions about your asylum or other protection claim (withholding of removal under 241(b)(3) of the INA or

withholding of removal under the Convention Against Torture), you must provide a detailed and specific account of the basis of your claim to asylum

or other protection. To the best of your ability, provide specific dates, places, and descriptions about each event or action described. You must attach

documents evidencing the general conditions in the country from which you are seeking asylum or other protection and the specific facts on which

you are relying to support your claim. If this documentation is unavailable or you are not providing this documentation with your application, explain

why in your responses to the following questions.

Refer to Instructions, Part 1: Filing Instructions, Section II, "Basis of Eligibility," Parts A - D, Section V, Completing the Form," Part B, and Section

VII, "Additional Evidence That You Should Submit," for more information on completing this section of the form.

I am seeking asylum or withholding of removal based on:

Race

No

No

Form I-589 Edition 01/20/25

Page 6 of 12

2.

Have you or your family members ever been accused, charged, arrested, detained, interrogated, convicted and sentenced, or imprisoned in any

country other than the United States (including for an immigration law violation)?

Yes

If "Yes," explain the circumstances and reasons for the action.

3.A.

Have you or your family members ever belonged to or been associated with any organizations or groups in your home country, such as, but not

limited to, a political party, student group, labor union, religious organization, military or paramilitary group, civil patrol, guerrilla organization,

ethnic group, human rights group, or the press or media?

Yes

If "Yes," describe for each person the level of participation, any leadership or other positions held, and the length of time you or your family

members were involved in each organization or activity.

3.B.

Do you or your family members continue to participate in any way in these organizations or groups?

Yes

If "Yes," describe for each person your or your family members' current level of participation, any leadership or other positions currently held,

and the length of time you or your family members have been involved in each organization or group.

4.

Are you afraid of being subjected to torture in your home country or any other country to which you may be returned?

Yes

If "Yes," explain why you are afraid and describe the nature of torture you fear, by whom, and why it would be inflicted.

Part B. Information About Your Application

(continued)

No

No

No

No

Form I-589 Edition 01/20/25

Page 7 of 12

(

NOTE:

Use Form I-589 Supplement B, or attach additional sheets of paper as needed to complete your responses to the questions contained in

Part C.

)

Part C. Additional Information About Your Application

1.

Have you, your spouse, your child(ren), your parents or your siblings ever applied to the U.S. Government for refugee status, asylum, or

withholding of removal?

Yes

If "Yes," explain the decision and what happened to any status you, your spouse, your child(ren), your parents, or your siblings received as a

result of that decision. Indicate whether or not you were included in a parent or spouse's application. If so, include your parent or spouse's

A-number in your response. If you have been denied asylum by an immigration judge or the Board of Immigration Appeals, describe any

change(s) in conditions in your country or your own personal circumstances since the date of the denial that may affect your eligibility for

asylum.

If "Yes" to either or both questions (2A and/or 2B), provide for each person the following: the name of each country and the length of stay, the

person's status while there, the reasons for leaving, whether or not the person is entitled to return for lawful residence purposes, and whether the

person applied for refugee status or for asylum while there, and if not, why he or she did not do so.

Yes

Yes

3.

Have you, your spouse or your child(ren) ever ordered, incited, assisted or otherwise participated in causing harm or suffering to any person

because of his or her race, religion, nationality, membership in a particular social group or belief in a particular political opinion?

Yes

If "Yes," describe in detail each such incident and your own, your spouse's, or your child(ren)'s involvement.

2.A.

After leaving the country from which you are claiming asylum, did you or your spouse or child(ren) who are now in the United States travel

through or reside in any other country before entering the United States?

2.B.

Have you, your spouse, your child(ren), or other family members, such as your parents or siblings, ever applied for or received any lawful status

in any country other than the one from which you are now claiming asylum?

No

No

No

No

Form I-589 Edition 01/20/25

Page 8 of 12

Part C. Additional Information About Your Application

(continued)

4.

After you left the country where you were harmed or fear harm, did you return to that country?

Yes

If "Yes," describe in detail the circumstances of your visit(s) (for example, the date(s) of the trip(s), the purpose(s) of the trip(s), and the length

of time you remained in that country for the visit(s).)

5.

Are you filing this application more than 1 year after your last arrival in the United States?

Yes

If "Yes," explain why you did not file within the first year after you arrived. You must be prepared to explain at your interview or hearing why

you did not file your asylum application within the first year after you arrived. For guidance in answering this question, see Instructions, Part 1:

Filing Instructions, Section V. "Completing the Form," Part C.

No

No

6.

Have you or any member of your family included in the application ever committed any crime and/or been arrested, charged, convicted, or

sentenced for any crimes in the United States (including for an immigration law violation)?

Yes

If "Yes," for each instance, specify in your response: what occurred and the circumstances, dates, length of sentence received, location, the

duration of the detention or imprisonment, reason(s) for the detention or conviction, any formal charges that were lodged against you or your

relatives included in your application, and the reason(s) for release. Attach documents referring to these incidents, if they are available, or an

explanation of why documents are not available.

No

Form I-589 Edition 01/20/25

Image 1

Page 9 of 12

Part D. Your Signature

Daytime Telephone Number

I certify, under penalty of perjury under the laws of the United States of America, that this application and the evidence submitted with it are all true

and correct. Title 18, United States Code, Section 1546(a), provides in part: Whoever knowingly makes under oath, or as permitted under penalty of

perjury under Section 1746 of Title 28, United States Code, knowingly subscribes as true, any false statement with respect to a material fact in any

application, affidavit, or other document required by the immigration laws or regulations prescribed thereunder, or knowingly presents any such

application, affidavit, or other document containing any such false statement or which fails to contain any reasonable basis in law or fact - shall be

fined in accordance with this title or imprisoned for up to 25 years. I certify that I am physically present in the United States or seeking admission at

a Port of Entry when I execute this application. I authorize the release of any information from my immigration record that U.S. Citizenship and

Immigration Services (USCIS) needs to determine eligibility for the benefit I am seeking.

WARNING:

Applicants who are in the United States

unlawfully

are subject to removal if their asylum or withholding claims are not

granted by an asylum officer or an immigration judge. Any information provided in completing this application may be used as a basis for

the institution of, or as evidence in, removal proceedings even if the application is later withdrawn. Applicants determined to have

knowingly made a frivolous application for asylum will be permanently ineligible for any benefits under the Immigration and Nationality

Act. You may not avoid a frivolous finding simply because someone advised you to provide false information in your asylum application. If

filing with USCIS, unexcused failure to appear for an appointment to provide biometrics (such as fingerprints) and your biographical

information within the time allowed may result in an asylum officer dismissing your asylum application or referring it to an immigration

judge. Failure without good cause to provide DHS with biometrics or other biographical information while in removal proceedings may

result in your application being found abandoned by the immigration judge. See sections 208(d)(5)(A) and 208(d)(6) of the INA and 8 CFR

sections 208.10, 1208.10, 208.20, 1003.47(d) and 1208.20.

Print your complete name.

Write your name in your native alphabet.

Did your spouse, parent, or child(ren) assist you in completing this application?

Yes

(If "Yes," list the name and relationship.)

(Name)

(Relationship)

(Name)

(Relationship)

Did someone other than your spouse, parent, or child(ren) prepare this application?

Yes

(If "Yes,"complete Part E.)

Asylum applicants may be represented by counsel. Have you been provided with a list of

persons who may be available to assist you, at little or no cost, with your asylum claim?

Yes

Signature of Applicant

(The person in Part. A.I.)

Sign your name so it all appears within the brackets

[

]

Part E. Declaration of Person Preparing Form, if Other Than Applicant, Spouse, Parent, or Child

I declare that I have prepared this application at the request of the person named in Part D, that the responses provided are based on all information of

which I have knowledge, or which was provided to me by the applicant, and that the completed application was read to the applicant in his or her

native language or a language he or she understands for verification before he or she signed the application in my presence. I am aware that the

knowing placement of false information on the Form I-589 may also subject me to civil penalties under 8 U.S.C. 1324c and/or criminal penalties

under 18 U.S.C. 1546(a).

Signature of Preparer

Print Complete Name of Preparer

Apt. Number

City

State

Zip Code

Address of Preparer: Street Number and Name

)

(

No

No

No

Attorney State Bar Number

(if

applicable)

Select this box if

Form G-28 is

attached.

Attorney or Accredited Representative

USCIS Online Account Number

(if any)

To be completed by an

attorney or accredited

representative

(if any)

.

Date (mm/dd/yyyy)

Form I-589 Edition 01/20/25

Page 10 of 12

Part F. To Be Completed at Asylum Interview, if Applicable

NOTE:

You will be asked to complete this part when you appear for examination before an asylum officer of the Department of Homeland Security,

U.S. Citizenship and Immigration Services (USCIS).

I swear (affirm) that I know the contents of this application that I am signing, including the attached documents and supplements, that they are

all true or not all true to the best of my knowledge and that correction(s) numbered to were made by me or at my request.

Furthermore, I am aware that if I am determined to have knowingly made a frivolous application for asylum I will be permanently ineligible for any

benefits under the Immigration and Nationality Act, and that I may not avoid a frivolous finding simply because someone advised me to provide

false information in my asylum application.

Signed and sworn to before me by the above named applicant on:

Date

(mm/dd/yyyy)

Signature of Asylum Officer

Write Your Name in Your Native Alphabet

Signature of Applicant

Part G. To Be Completed at Removal Hearing, if Applicable

NOTE:

You will be asked to complete this Part when you appear before an immigration judge of the U.S. Department of Justice, Executive Office

for Immigration Review (EOIR), for a hearing.

I swear (affirm) that I know the contents of this application that I am signing, including the attached documents and supplements, that they are

all true or not all true to the best of my knowledge and that correction(s) numbered

to

were made by me or at my request.

Furthermore, I am aware that if I am determined to have knowingly made a frivolous application for asylum I will be permanently ineligible for any

benefits under the Immigration and Nationality Act, and that I may not avoid a frivolous finding simply because someone advised me to provide

false information in my asylum application.

Signed and sworn to before me by the above named applicant on:

Date

(mm/dd/yyyy)

Signature of Immigration Judge

Write Your Name in Your Native Alphabet

Signature of Applicant

Form I-589 Edition 01/20/25

Image 1

Page 11 of 12

A-Number

(If available)

Date

Applicant's Name

Applicant's Signature

List All of Your Children, Regardless of Age or Marital Status

(

NOTE:

Use this form and attach additional pages and documentation as needed, if you have more than four children)

13.

Is this child in the U.S. ?

5.

Complete Last Name

9.

City and Country of Birth

6.

First Name

7.

Middle Name

8.

Date of Birth

(mm/dd/yyyy)

10.

Nationality

(Citizenship)

11.

Race, Ethnic, or Tribal Group

12.

Sex

14.

Place of last entry into the U.S.

15.

Date of last entry into the

U.S.

(mm/dd/yyyy)

16.

I-94 Number

(If any)

17.

Status when last admitted

(Visa type, if any)

18.

What is your child's current status?

19.

What is the expiration date of his/her

authorized stay, if any?

(mm/dd/yyyy)

20.

Is your child in Immigration Court proceedings?

21.

If in the U.S., is this child to be included in this application?

(Check the appropriate box.)

1.

Alien Registration Number (A-Number)

(if any)

2.

Passport/ID Card Number

(if any)

3.

Marital Status

(Married, Single,

Divorced, Widowed)

4.

U.S. Social Security Number

(if any)

Male

Female

Yes

No

Yes

No

Yes

(Complete Blocks 14 to 21.)

No

(Specify location)

:

13.

Is this child in the U.S. ?

5.

Complete Last Name

9.

City and Country of Birth

6.

First Name

7.

Middle Name

8.

Date of Birth

(mm/dd/yyyy)

10.

Nationality

(Citizenship)

11.

Race, Ethnic, or Tribal Group

12.

Sex

14.

Place of last entry into the U.S.

15.

Date of last entry into the

U.S.

(mm/dd/yyyy)

16.

I-94 Number

(If any)

17.

Status when last admitted

(Visa type, if any)

18.

What is your child's current status?

19.

What is the expiration date of his/her

authorized stay, if any?

(mm/dd/yyyy)

20.

Is your child in Immigration Court proceedings?

21.

If in the U.S., is this child to be included in this application?

(Check the appropriate box.)

1.

Alien Registration Number (A-Number)

(if any)

2.

Passport/ID Card Number

(if any)

3.

Marital Status

(Married, Single,

Divorced, Widowed)

4.

U.S. Social Security Number

(if any)

Male

Female

Yes

No

Yes

No

Yes

(Complete Blocks 14 to 21.)

No

(Specify location)

:

Form I-589 Supplement A Edition 01/20/25

Application for Asylum and for

Withholding of Removal Supplement A

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form I-589

OMB No. 1615-0069

Expires 09/30/2027

Image 1

Page 12 of 12

Additional Information About Your Claim to Asylum

Applicant's Signature

Date

A-Number

(if available)

Applicant's Name

NOTE:

Use this as a continuation page for any additional information requested. Copy and complete as needed.

Part

Question

Form I-589 Supplement B Edition 01/20/25

Application for Asylum and for

Withholding of Removal Supplement B

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form I-589

OMB No. 1615-0069

Expires 09/30/2027