Form G-325A Biographic Information

OMB No. 1615-0008; Expires 10/31/2019

G-325A, Biographic Information

Department of Homeland Security
U.S. Citizenship and Immigration Services
Family Name

(for Deferred Action)

First Name

Male

Middle Name

Date of Birth
(mm/dd/yyyy)

Citizenship/Nationality File Number

A

Female
All Other Names Used (include names by previous marriages)
Family Name

First Name

Father
Mother
(Maiden Name)
Current Husband or Wife (If none, so state)
Family Name (For wife, give maiden name)

City and Country of Birth
Date of Birth
(mm/dd/yyyy)

City, and Country of Birth
(if known)

U.S. Social Security No. (if any)

City and Country of Residence

DRAFT
Not for
Production
01/24/2018
Date of Birth
(mm/dd/yyyy)

First Name

Former Husbands or Wives (If none, so state) First Name
Family Name (For wife, give maiden name)

Date of Birth
(mm/dd/yyyy)

City and Country of Birth

Date and Place of Marriage

Date of Marriage Place of Marriage

Date and Place of Termination of
Marriage

Applicant's residence last five years. List present address first.
Street Name and Number

City

Province or State

Country

From
Month
Year

Month

To

Year

Present Time

Applicant's last address outside the United States of more than 1 year.
Street Name and Number

City

Province or State

Country

From
Month
Year

Month

To

Year

Applicant's employment last five years. (If none, so state.) List present employment first.
Full Name and Address of Employer

Occupation (Specify)

From
Month
Year

Month

To

Year

Present Time

Last occupation abroad if not shown above. (Include all information requested above.)
This form is submitted in connection with an application for:
Naturalization

Date

Signature of Applicant

Other (Specify):

Status as Permanent Resident
If your native alphabet is in other than Roman letters, write your name in your native alphabet below:

Penalties: Severe penalties are provided by law for knowingly and willfully falsifying or concealing a material fact.

Applicant: Print your name and Alien Registration Number in the box outlined by heavy border below.
Complete This Box (Family Name)

(Given Name)

(Middle Name)

(Alien Registration Number)

A
Form G-325A (Rev. 10/19/17) N

Instructions
What Is the Purpose of This Form?
USCIS will use the information you provide on this form to process your application or petition.
Complete this biographical information form and include it with the application or petition you are submitting to U.S. Citizenship and
Immigration Services (USCIS).
If you have any questions on how to complete the form, call our National Customer Service Center at 1-800-375-5283. For TTY
(hearing impaired) call: 1-800-767-1833.

DRAFT
Not for
Production
01/24/2018

USCIS Privacy Act Statement

AUTHORITIES: The information requested on this benefit application, and the associated evidence, is collected under the
Immigration and Nationality Act (INA) section 103 and 8 U.S.C. 1103(a)(1), which gives the Secretary of Homeland Security (the
Secretary) general authority to enforce and administer the immigration laws.
PURPOSE: The primary purpose for providing the requested information on this form is to determine eligibility of discretionary
deferred action on a case-by-case basis, for certain family members of military personnel, military personnel who previously served,
and Delayed Entry Program enlistees. The Department of Homeland Security (DHS) will use the information you provide to grant or
deny the immigration benefit you are seeking.
DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and any
requested evidence, may delay the naturalization process.
ROUTINE USES: DHS may share the information you provide on this form with other Federal, state, local, and foreign government
agencies and other authorized organizations. DHS follows approved routine uses described in the associated published system of
records notices [DHS/USCIS-007 - Benefits Information System, October 19, 2016, 81 FR 72069 and DHS/USCIS/ICE/CBP-001 Alien File, Index, and National File Tracking System of Records, November 21, 2013, 78 FR 69864 (A-File)] which you can find at
www.dhs.gov/privacy. DHS may also share the information, as appropriate, for law enforcement purposes or in the interest of
national security.

Paperwork Reduction Act

An agency may not conduct or sponsor an information collection and a person is not required to respond to a collection of information
unless it displays a currently valid OMB control number. The public reporting burden for this collection of information is estimated at
2 hours and 9 minutes per response, including the time for reviewing instructions and completing and submitting the form. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this
burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy,
20 Massachusetts Avenue, NW, Washington, DC 20529-2140, OMB No. 1615-0008. Do not mail your completed Form G-325A to
this address.

Form G-325A (Rev. 10/19/17) N Page 2