Form G-325A Biographic Information

OMB No. 1615-0008; Expires 08/31/2025

G-325A, Biographic Information

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

Family Name

(for Deferred Action)

First Name

Date of Birth
(mm/dd/yyyy)

Male

Middle Name

Citizenship/Nationality

Female

File Number

A

DRAFT
NOT FOR
PRODUCTION
09/26/2023

All Other Names Used (include names by previous marriages)

Family Name

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

City and Country of Birth

Date of Birth
(mm/dd/yyyy)

First Name

City, and Country of Birth
(if known)

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

Date of Birth
(mm/dd/yyyy)

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

Date of Birth
(mm/dd/yyyy)

City and Country of
Birth

City and Country of Residence

Date of Marriage
(mm/dd/yyyy)

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

ZIP Code/
Postal Code

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

ZIP Code/
Postal Code

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:

Signature of Applicant

Date (mm/dd/yyyy)

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)

(Alien Registration Number)

(Middle Name)

A
Form G-325A (Rev. 08/30/22)