G-325a Toc

TABLE OF CHANGES – FORM

Form G-325A, Biographic Information 9for Deferred Action)

OMB Number: 1615-0008

03/29/2021

Reason for Revision: PRA Review

Legend for Proposed Text:

• Black font = Current text

• Red font = Changes

Expires 09/30/2022

Edition Date 09/17/2019

Current Page Number and Section	Current Text	Proposed Text
Page 1	[Page 1] Family Name First Name Middle Name Male Female Date of Birth (mm/dd/yyyy) Citizenship/Nationality File Number All Other Names Used (include names by previous marriages) City and Country of Birth U.S. Social Security No. (if any) Father Family Name First Name Date of Birth (mm/dd/yyyy) City, and Country of Birth (if known) City and Country of Residence Mother Family Name (Maiden Name) First Name Date of Birth (mm/dd/yyyy) City, and Country of Birth (if known) City and Country of Residence Current Husband or Wife (If none, so state) Family Name (For wife, give maiden name) First Name Date of Birth (mm/dd/yyyy) Date and Place of Marriage Date and Place of Termination of Marriage Applicant’s residence last five years. List present address first. [Table 5 entries] Street Name and Number City Province or State Country From Month Year To Month Year [“Present Time” in 1st entry] 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 To Month Year Applicant’s employment last five years. (If none, so state.) List present employment first. [Table 5 entries] Full Name and Address of Employer Occupation (Specify) From Month Year To Month Year [“Present Time” in 1st entry] Last occupation abroad if not shown above. (Include all information requested above.) This form is submitted in connection with an application for: Naturalization Status as Permanent Resident Other (Specify): Signature of Applicant Date If your native alphabet is in other than Roman letters, write your name in your native alphabet below: [Fillable field] 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)	[Page 1] [no change] This form is submitted for: Deferred Action Request [delete] [delete] [no change]

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