G-325A Form - Table of Changes

G325A-008-FRM-REV-TOC-30Day-06072022.docx

Biographic Information (for Deferred Action)

G-325A Form - Table of Changes

OMB: 1615-0008

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TABLE OF CHANGES – FORM

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

OMB Number: 1615-0008

06/06/2022


Reason for Revision: Revision

Project Phase: 30 Day


Legend for Proposed Text:

  • Black font = Current text

  • Red font = Changes


Expires 09/30/2022

Edition Date 04/08/2021



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)

City, and Country of Birth

Date of Marriage

Place of Marriage


Former Husbands or Wives (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 for:

[x] Deferred Action Request


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]

































Current Husband or Wife (If none, type or print “none”)

[no change]







Former Husbands or Wives (If none, type or print “none”)

[no change]



























Applicant’s employment last five years. (If none, type or print “none.) List present employment first.


[no change]

Page 2,

Instructions

[Page 2]


Instructions

[moved to separate Instructions document]

Page 2,

What Is the Purpose of This Form?

[Page 2]


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 submitted 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.


[moved to separate Instructions document]

Page 2,

DHS Privacy Notice

[Page 2]


DHS Privacy Notice


AUTHORITIES: The information requested on this application, and the associated evidence, is collected pursuant to Section 103 of the Immigration and Nationality Act, 8 U.S.C. 1103(a)(1).


PURPOSE: The primary purpose for providing the requested information on this application is to collect information to locate an immigration record to determine eligibility for the benefit you are requesting.


DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, including your Social Security number (if applicable), and any requested evidence, may delay a final decision or result in denial of your application.


ROUTINE USES: DHS may share the information you provide on this application 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/ICE/CBP-001 - Alien File, Index, and National File Tracking System and DHS/USCIS-007 - Benefits Information System] and the published privacy impact assessment [DHS/USCIS/PIA-061 Benefit Request Intake Process], which can be found at www.dhs.gov/privacy. DHS may also share the information, as appropriate, for law enforcement purposes or in the interest of national security.


[moved to separate Instructions document]

Page 2,

Paperwork Reduction Act

[Page 2]


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 of reducing this burden, to: U.S. Citizenship and Immigration Services, Office of Policy and Strategy, Regulatory Coordination Division, 5900 Capital Gateway Drive, Mail Stop #2140, Camp Springs, MD 20588-0009; OMB No. 1615-0008. Do not mail your completed Form G-325A to this address.


[moved to separate Instructions document]


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorLauver, James L
File Modified0000-00-00
File Created2022-08-28

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