G-325A Form - Table of Changes

G325A-010-FRM-TOC-83C-OMBReview-09262023.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

09/26/2023


Reason for Revision: 83C

Project Phase: OMBReview


Legend for Proposed Text:

  • Black font = Current text

  • Red font = Changes


Expires 08/31/2025

Edition Date 08/30/2022



Current Page Number and Section

Current Text

Proposed Text

Page 1, Biographic Information

[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, type or print “none”)

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, type or print “none”)

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


[no change]

Page 1, Applicant’s residence

[Page 1]


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 residence last five years. List present address first.


[Table 5 entries]

Street Name and Number

City

Province or State

ZIP Code/Postal Code

Country

From Month Year

To Month Year [“Present Time” in 1st entry]

Page 1, Applicant’s last address

[Page 1]


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 last address outside the United States of more than 1 year.


Street Name and Number

City

Province or State

ZIP Code/Postal Code

Country

From Month Year

To Month Year


Page 1, Applicant’s employment

[Page 1]


Applicant’s employment last five years. (If none, type or print “none.”) 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]




[no change]

Page 1, Last occupation

[Page 1]


Last occupation abroad if not shown above. (Include all information requested above.)




[no change]

Page 1, This form is submitted for

[Page 1]


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)




[no change]







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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorValentine, Brian R
File Modified0000-00-00
File Created2023-10-12

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