Form G-325A Biographic Information

OMB No. 1615-0008; Expires 09/30/2022

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

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

Family Name

First Name

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

City and Country of Birth

Date of Birth
(mm/dd/yyyy)

City, and Country of Birth
(if known)

City and Country of Residence

DRAFT
Not for
Production
06/07/2022

Father
Mother
(Maiden Name)
Current Husband or Wife (If none, type or print
"none") Family Name (For wife, give maiden name)

Former Husbands or Wives (If none, type or print
"none") Family Name (For wife, give maiden name)

First Name

Date of Birth
(mm/dd/yyyy)

First Name

Date of Birth
(mm/dd/yyyy)

City and Country of
Birth

Date of Marriage

Date and Place 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

From
Month
Year

Country

To
Month

Year

Present Time

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

City

Province or State

From
Month
Year

Country

To
Month

Year

Applicant's employment last five years. (If none, type or print "none.") List present employment first.
Full Name and Address of Employer

Occupation (Specify)

From
Month
Year

To
Month

Year

Present Time

Last occupation abroad if not shown above. (Include all information requested above.)
This form is submitted for:

Date

Signature of Applicant

Deferred Action Request
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. 04/08/21)