[Page 2]
Part
A.II. Information About Your Spouse and Children
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Part A.II. Information
About Your Spouse and Children
Your
spouse I am
not married. (Skip to Your
Children below.)
1.
Alien Registration Number (A-Number) (if
any)
2.
Passport/ID Card Number (if
any)
3.
Date of Birth (mm/dd/yyyy)
4.
U.S. Social Security Number (if
any)
5.
Complete Last Name
6.
First Name
7.
Middle Name
8.
Other names used (include
maiden name and aliases)
9.
Date of Marriage (mm/dd/yyyy)
10.
Place of Marriage
11.
City and Country of Birth
12.
Nationality (Citizenship)
13.
Race, Ethnic, or Tribal Group
14.
Gender
Male
Female
15.
Is this person in the U.S.?
Yes
(Complete Blocks
16 to 24.)
No
(Specify
location):
[Fillable field
16.
Place of last entry into the U.S.
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)
20.
What is your spouse's current status?
21.
What is the expiration date of his/her authorized stay, if any?
(mm/dd/yyyy)
22.
Is your spouse in Immigration Court proceedings?
Yes
No
23.
If previously in the U.S., date of previous arrival (mm/dd/yyyy)
24.
If in the U.S., is your spouse to be included in this
application? (Check
the appropriate box.)
Yes
(Attach one
photograph of your spouse in the upper right corner of Page 9 on
the extra copy of the application submitted for this person.)
No
Your
Children. List
all
of your children, regardless of age, location, or marital status.
I
do not have any children. (Skip
to Part A.III., Information about your background.)
I
have children.
Total
number of children: [Fillable field]
|
Part A.II. Information
About Your Spouse and Children
Your
spouse I am
not married. (Skip to Your
Children below.)
1.
Alien Registration Number (A-Number) (if
any)
2.
Passport/ID Card Number (if
any)
3.
Date of Birth (mm/dd/yyyy)
4.
U.S. Social Security Number (if
any)
5.
Complete Last Name
6.
First Name
7.
Middle Name
8.
Other names used (include
maiden name and aliases)
9.
Date of Marriage (mm/dd/yyyy)
10.
Place of Marriage
11.
City and Country of Birth
12.
Nationality (Citizenship)
13.
Race, Ethnic, or Tribal Group
14.
Gender
Male
Female
15.
Is this person in the U.S.?
Yes
(Complete
Blocks 16 to 24.)
No
(Specify
location):
[Fillable field
16.
Place of last entry into the U.S.
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)
20.
What is your spouse's current status?
21.
What is the expiration date of his/her authorized stay, if any?
(mm/dd/yyyy)
22.
Is your spouse in Immigration Court proceedings?
Yes
No
23.
If previously in the U.S., date of previous arrival (mm/dd/yyyy)
24.
If in the U.S., is your spouse to be included in this
application? (Check
the appropriate box.)
Yes
(Attach one
photograph of your spouse in the upper right corner of Page 9 on
the extra copy of the application submitted for this person.)
No
Your
Children. List
all
of your children, regardless of age, location, or marital status.
I
do not have any children. (Skip
to
Part
A.III.,
Information
about your background.)
I
have children.
Total
number of children: [Fillable field]
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[Page 8]
Part
C. Additional Information About Your Application
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[Page 8]
Part
C. Additional 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 C.)
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?
No
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.
[Fillable
field]
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?
No
Yes
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
Yes
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.
[Fillable
field]
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?
No
Yes
If
"Yes," describe in detail each such incident and your
own, your spouse's, or your child(ren)'s involvement.
[Fillable
field]
[Page
8]
4.
After you left the country where you were harmed or fear harm,
did you return to that country?
No
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).)
[Fillable
field]
5.
Are you filing this application more than 1 year after your last
arrival in the United States?
No
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.
[Fillable
field]
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)?
No
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.
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[Page 8]
Part
C. Additional 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 C.)
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?
No
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 were
previously denied
asylum by USCIS,
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.
[Fillable
field]
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?
No
Yes
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
Yes
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.
[Fillable
field]
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?
No
Yes
If
"Yes," describe in detail each such incident and your
own, your spouse's, or your child(ren)'s involvement.
[Fillable
field]
[Page
8]
4.
After you left the country where you were harmed or fear harm,
did you return to that country?
No
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).)
[Fillable
field]
5.
Are you filing this application more than 1 year after your last
arrival in the United States?
No
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.
[Fillable
field]
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)?
No
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.
If
you have been arrested in the United States, you must submit a
certified copy of all arrest reports, court dispositions,
sentencing documents, and any other relevant documents.
[Fillable
field]
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