I-589 Asylum Application

I-589 Asylum Application
Applicant Identity and Contact Information
A-Number
USCIS Online Account Number
Social Security Number
Last Name
First Name
Middle Name
Other Names Used / Maiden Name / Aliases
Physical Address - Street
Physical Address - City
Physical Address - State
Physical Address - ZIP Code
Mailing Address - Street
Mailing Address - City
Mailing Address - State
Mailing Address - ZIP Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Sex
Marital Status
Birth, Nationality, Language, and Immigration Information
City of Birth
Country of Birth
Current Nationality
Nationality at Birth
Race / Ethnic / Tribal Group
Religion
Immigration Court Status
Date of Last Departure from Home Country

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
I-94 Number
All Entries to the U.S.
Passport Country of Issuance
Passport Number
Passport Expiration Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Native Language
Are you fluent in English?
Other Languages
Apply for protection under the Convention Against Torture (CAT)
Spouse and Children
Current marital status

Other
Spouse full name

First NameMiddle NameLast Name
Spouse date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Spouse country of birth
Spouse nationality
Spouse current location
Spouse A-Number
Spouse alien registration number
Is your spouse in the United States?
Have you ever been married before?
Child 1 full name

First NameMiddle NameLast Name
Child 1 date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child 1 relationship to you
Child 1 current location
Child 2 full name

First NameMiddle NameLast Name
Child 2 date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child 2 relationship to you
Child 2 current location
Do you have any children?
Additional spouse or children information
Background, Address, Education, and Employment History
Have you ever completed any education, from primary school onward?
Addresses where you have lived since your arrival in the United States
Places you have lived for one year or more since your 16th birthday
Highest level of education completed
Schools, colleges, or universities attended
Employment history since your 16th birthday
Were you ever employed by any government, military, police, or intelligence organization?
Explain any periods of unemployment since age 16
Have you ever belonged to, or been associated with, any organization or group?
Describe any organizations or groups you belonged to or were associated with
Current employment status
Family Background
Mother's full name

First NameMiddle NameLast Name
Mother's date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Mother's current status
Father's full name

First NameMiddle NameLast Name
Father's date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Father's current status
Sibling information
Additional family background details
Basis of Asylum Claim and Narrative
Basis of asylum claim

Other
Describe past harm or mistreatment you experienced
Who caused the harm or mistreatment?
Why do you believe you were harmed or targeted?
Have you ever been arrested, detained, threatened, or attacked because of your beliefs or identity?
Do you fear harm if you return to your home country? Explain why.
Have you reported the harm to police, government officials, or any organization? If not, explain why.
Provide any additional details about your asylum claim and future fear of harm
Security and Eligibility
Are you now in the custody of any law enforcement agency, prison, or detention center?
If yes, explain where you are being held and why.
Have you ever ordered, incited, assisted, or otherwise participated in the persecution of any person because of race, religion, nationality, membership in a particular social group, or political opinion?
If yes, explain your involvement.
Have you ever committed, assisted, or otherwise participated in genocide?
If yes, explain.
Have you ever committed, assisted, or otherwise participated in any extrajudicial killing?
If yes, explain.
Have you ever committed, assisted, or otherwise participated in any act of torture?
If yes, explain.
Have you ever committed, assisted, or otherwise participated in any terrorist activity?
If yes, explain.
Are you currently a member of or affiliated with any organization, association, fund, foundation, party, club, society, or similar group in the United States or any other country that uses force, violence, or other unlawful means to further political, religious, racial, social, or other goals?
If yes, explain.
Have you ever been a member of or associated with a group that used force, violence, or other unlawful means to further political, religious, racial, social, or other goals?
If yes, explain.
Have you ever helped, assisted, or otherwise provided support to any group or individual who has committed, assisted, or otherwise participated in persecution?
If yes, explain.
Have you ever served in, been a member of, or otherwise participated in a military unit, militia, police unit, self-defense unit, vigilante unit, rebel group, guerrilla group, paramilitary unit, or similar organization?
If yes, explain your role, the dates you served, and the place of service.
Certification, Signature, and Warning Acknowledgment
Applicant Certification Statement
Applicant Signature
Applicant Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Warning Acknowledgment
Warning Section Signature
Warning Section Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

I-589 Asylum Application

Applicant Identity and Contact Information

Birth, Nationality, Language, and Immigration Information

Spouse and Children

Background, Address, Education, and Employment History

Family Background

Basis of Asylum Claim and Narrative

Security and Eligibility

Certification, Signature, and Warning Acknowledgment