I-589-Application for Asylum and for Withholding of Removal

I-589, Application for Asylum and for Withholding of Removal

1. Fill out the form 2. Pay 3. Receive Completed Form in Editable PDF
Part A1- Information About You
Do you also want to apply for withholding of removal under the Convention Against Torture*
Alien Registration Number(s) (A-Number) (if any)
U.S. Social Security Number (if any)
USCIS Online Account Number (if any)
Complete Last Name*
First Name*
Middle Name
What other names have you used (include maiden name and aliases)?
Residence in the U.S. (where you physically reside)*

Street Address

Apt. Number

CityState

Zip Code
Telephone Number*

Area CodePhone Number
In Care Of (if applicable)
Full Name
Telephone Number

Area CodePhone Number
Mailing Address in the U.S. (if different than the address above)

Street Address

Apt. Number

CityState

Zip Code
Gender*

MaleFemale
Marital Status*

SingleMarriedDivorcedWidowed
Date of Birth*

MonthDayYear
City and Country of Birth*
Present Nationality (Citizenship)*
Nationality at Birth*
Race, Ethnic, or Tribal Group
Religion*
Select the option that applies to you*
When did you last leave your country?*

MonthDayYear
What is your current I-94 Number (if any)
List each entry into the U.S. beginning with your most recent entry. List date, place, and your status for each entry.

Most Recent Entry (Required)
Most Recent Entry Date*

MonthDayYear
Most Recent Place of Entry*
Status of Most Recent Entry*
Date Status Expires*

MonthDayYear
Entry 2 (if applicable)
Date 1

MonthDayYear
Place 1
Status 1
Entry 3 (if applicable)
Date 2

MonthDayYear
Place 2
Status 2
What country issued your last passport or travel document?*
Passport Number*
Travel Document Number
Expiration Date*

MonthDayYear
What is your native language (include dialect, if applicable)*
Are you fluent in English?*
What other languages do you speak fluently?
Part A2 - Information About Your Spouse and Children
Are you married*

YesNo
Information about your spouse
Alien Registration Number (A-Number) (if any)
Passport/ID Card Number (if any)
Date of Birth*

MonthDayYear
U.S. Social Security Number (if any)
Complete Last Name*
First Name*
Middle Name
Other names used (include maiden name and aliases)
Date of Marriage*

MonthDayYear
Place of Marriage*
City and Country of Birth*
Nationality (Citizenship)*
Race, Ethnic, or Tribal Group
Gender*

MaleFemale
Is this person in the U.S.?*

YesNo
Specify current location
Place of last entry into the U.S.
Date of last entry into the U.S. (mm/dd/yyyy)

MonthDayYear
I-94 Number (if any)
Status when last admitted (Visa type, if any)
What is your spouse's current status?
What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy)

MonthDayYear
Is your spouse in Immigration Court proceedings?

YesNo
If previously in the U.S., date of previous arrival

MonthDayYear
If in the U.S., is your spouse to be included in this application? (Check the appropriate box.)

YesNo
Do you have children?*

YesNo
Information about your children

List all of your children, regardless of age, location, or marital status.
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.)
Child 1
Alien Registration Number (A-Number)(if any)
Passport/ID Card Number (if any)
Marital Status*

MarriedSingleDivorcedWidowed
U.S. Social Security Number (if any)
Complete Last Name*
First Name*
Middle Name
Date of Birth*

MonthDayYear
City and Country of Birth*
Nationality (Citizenship) *
Race, Ethnic, or Tribal Group
Gender*

MaleFemale
Is this child in the U.S. ?*

YesNo
If No, Specify Location*
Place of last entry into the U.S.*
Date of last entry into the U.S.*

MonthDayYear
I-94 Number (If any)
Status when last admitted (Visa type, if any)
What is your child's current status?*
e.g. US Citizen, lawful permanent resident, Temporary Protected Status, in removal proceedings, asylum pending, undocumented, outside of the United States, other status (please explain)
What is the expiration date of his/her authorized stay, if any?

MonthDayYear
Is your child in Immigration Court proceedings?*

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

YesNo
Child 2
Alien Registration Number (A-Number)(if any)
Passport/ID Card Number (if any)
Marital Status*

MarriedSingleDivorcedWidowed
U.S. Social Security Number (if any)
Complete Last Name*
First Name*
Middle Name
Date of Birth*

MonthDayYear
City and Country of Birth*
Nationality (Citizenship) *
Race, Ethnic, or Tribal Group
Gender*

MaleFemale
Is this child in the U.S. ?*

YesNo
Specify Location*
Place of last entry into the U.S.*
Date of last entry into the U.S.*

MonthDayYear
I-94 Number (If any)
Status when last admitted (Visa type, if any)
What is your child's current status?*
e.g. US Citizen, lawful permanent resident, Temporary Protected Status, in removal proceedings, asylum pending, undocumented, outside of the United States, other status (please explain)
What is the expiration date of his/her authorized stay, if any?

MonthDayYear
Is your child in Immigration Court proceedings?*

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

YesNo
Child 3
Alien Registration Number (A-Number)(if any)
Passport/ID Card Number (if any)
Marital Status*

MarriedSingleDivorcedWidowed
U.S. Social Security Number (if any)
Complete Last Name*
First Name*
Middle Name
Date of Birth*

MonthDayYear
City and Country of Birth*
Nationality (Citizenship) *
Race, Ethnic, or Tribal Group
Gender*

MaleFemale
Is this child in the U.S. ?*

YesNo
Specify Location*
Place of last entry into the U.S.*
Date of last entry into the U.S.*

MonthDayYear
I-94 Number (If any)
Status when last admitted (Visa type, if any)
What is your child's current status?*
e.g. US Citizen, lawful permanent resident, Temporary Protected Status, in removal proceedings, asylum pending, undocumented, outside of the United States, other status (please explain)
What is the expiration date of his/her authorized stay, if any?

MonthDayYear
Is your child in Immigration Court proceedings?*

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

YesNo
Child 4
Alien Registration Number (A-Number)(if any)
Passport/ID Card Number (if any)
Marital Status*

MarriedSingleDivorcedWidowed
U.S. Social Security Number (if any)
Complete Last Name*
First Name*
Middle Name
Date of Birth*

MonthDayYear
City and Country of Birth*
Nationality (Citizenship) *
Race, Ethnic, or Tribal Group
Gender*

MaleFemale
Is this child in the U.S. ?*

YesNo
Specify Location*
Place of last entry into the U.S.*
Date of last entry into the U.S.*

MonthDayYear
I-94 Number (If any)
Status when last admitted (Visa type, if any)
What is your child's current status?*
e.g. US Citizen, lawful permanent resident, Temporary Protected Status, in removal proceedings, asylum pending, undocumented, outside of the United States, other status (please explain)
What is the expiration date of his/her authorized stay, if any?

MonthDayYear
Is your child in Immigration Court proceedings?*

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

YesNo
Part A3 - Information About Your Background
1. Where did you live before coming to the United States

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. Make sure you enter "FROM" and "TO" entries correctly.

	Number and Street	City/Town	Provine/ State	Country	FROM (Month)	FROM (Year)	TO (Month)	TO (Year)
Service Quality
Cleanliness

2. Your residences during the last 5 years

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

	Number and Street	City/Town	Provine/ State	Country	FROM (Month)	FROM (Year)	TO (Month)	TO (Year)
Service Quality
Cleanliness
q
r
s
t
u

3. Information about your education

Provide the following information about your education, beginning with the most recent school that you attended.

	Name of School	Type of School	Address	City and Country	FROM (Month)	FROM (Year)	TO (Month)	TO (Year)
Service Quality
Cleanliness
q
r

4. Information about your employment

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

	Name of Employer	Address	City and Country	Occupation	FROM (Month)	FROM (Year)	TO (Month)	TO (Year)
Service Quality
Cleanliness
q

5. Information about your parents and siblings

A. Provide the following information about your MOTHER.

	Full Name	City/Town and Country of Birth	Current Location	Deceased
Service Quality

B. Provide the following information about your FATHER.

	Full Name	City/Town and Country of Birth	Current Location	Deceased
Service Quality

C. Provide the following information about SIBLING 1 (brother or sister).

	Full Name	City/Town and Country of Birth	Current Location	Deceased
Service Quality

D. Provide the following information about SIBLING 2 (brother or sister).

	Full Name	City/Town and Country of Birth	Current Location	Deceased
Service Quality

E. Provide the following information about SIBLING 3 (brother or sister).

	Full Name	City/Town and Country of Birth	Current Location	Deceased
Service Quality

F. Provide the following information about SIBLING 4 (brother or sister).

	Full Name	City/Town and Country of Birth	Current Location	Deceased
Service Quality

Part B - Information about your application
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.*

RaceReligionNationalityPolitical opinionMembership in a particular social groupTorture Convention
Have you, your family, or close friends or colleagues ever experienced harm or mistreatment or threats in the past by anyone?*
Do you fear harm or mistreatment if you return to your home country?*
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)?*
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?*
Do you or your family members continue to participate in any way in these organizations or groups?*
Are you afraid of being subjected to torture in your home country or any other country to which you may be returned?*
Part C - Additional Information About Your Application
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?*
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.

0/1000
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?*
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?*
If "Yes" to either or both questions (A and/or B), 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.

0/1000
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?*
If "Yes," describe in detail each such incident and your own, your spouse's, or your child(ren)'s involvement.

0/1000
After you left the country where you were harmed or fear harm, did you return to that country?*
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).

0/1000
Are you filing this application more than 1 year after your last arrival in the United States?*
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.

0/1000
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)?*
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.

0/1000
Part D - Your Signature
Did your spouse, parent, or child(ren) assist you in completing this application?*

Yes (If Yes, list the name and relationship below)No
Name
Relationship
Name
Relationship
Applicant's Signature*

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Today's Date*

MonthDayYear
Date
Part E - Declaration of Person Preparing Form, if Other Than Applicant, Spouse, Parent, or Child
Did someone other than your spouse, parent, or child(ren) prepare this application?*

Yes (If Yes, provide the information below)No
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?*

YesNo
Signature of Preparer*

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First Name of preparer
Last name of preparer
Phone Number

Area CodePhone Number
Address

Street Address

Apt. Number

CityState / Province

Postal / Zip Code
Upload Files and Documents

Submit The Following Files: A. Upload a hand-signed sworn declaration document in your native language in PDF or image format. B. Provide the text of your sworn declaration in your native language by entering the text in the designated text box below.
A. Upload a hand-signed sworn declaration document in one of the following file formats: PDF, MS Word, PNG, JPG. Document could be in English or in your native language. Important Note: Only one file is accepted.

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B. Copy and paste the text of your hand-signed sworn declaration document in the designated text box below. Text could be in English or in your native language.*

0/7000
Enter Text from Immigration Interview (if available).

0/7000
Recipient or Organization Name*
Recipient or Organization Email Address*

Confirmation EmailPlease re-enter email address
Please verify that you are human*
Should be Empty:

I-589, Application for Asylum and for Withholding of Removal

Part A1- Information About You

List each entry into the U.S. beginning with your most recent entry. List date, place, and your status for each entry.

Part A2 - Information About Your Spouse and Children

Information about your spouse

Information about your children

Child 1

Child 2

Child 3

Child 4

Part A3 - Information About Your Background

1. Where did you live before coming to the United States

2. Your residences during the last 5 years

3. Information about your education

4. Information about your employment

5. Information about your parents and siblings

Part B - Information about your application

Part C - Additional Information About Your Application

Part D - Your Signature

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

Upload Files and Documents