9. Mailing Address in the U.S. (if different than the address in Item Number 8) 8. Residence in the U.S. (where you physically reside) Telephone Number Telephone Number(Department of Homeland Security U.S. Citizenship and Immigration Services 18. Check the box, a through c, that applies:START HERE - Type or print in black ink. See the instructions for information about eligibility and how to complete and file this application. There is no filing fee for this application. Part A.I. Information About You 1. Alien Registration Number(s) (A-Number) (if any) 2. U.S. Social Security Number (if any) 4. Complete Last Name 7. What other names have you used (include maiden name and aliases)? Street Number and Name City 12. Date of Birth (mm/dd/yyyy) 14. Present Nationality (Citizenship) 5. First Name 6. Middle Name ) Apt. Number State Zip Code Apt. Number Street Number and Name Zip Code City State 10. Gender: Male Female 11. Marital Status: Single Married Divorced Widowed 13. City and Country of Birth 15. Nationality at Birth 16. Race, Ethnic, or Tribal Group 17. Religion I have never been in Immigration Court proceedings. I am not now in Immigration Court proceedings, but I have been in the past. I am now in Immigration Court proceedings.a.c.b. 19. Complete 19 a through c. a. When did you last leave your country? (mmm/dd/yyyy) b. What is your current I-94 Number, if any?c. List each entry into the U.S. beginning with your most recent entry. List date (mm/dd/yyyy), place, and your status for each entry. (Attach additional sheets as needed.) Date Place Status Date Place Status Date Place Status 20. What country issued your last passport or travel document? 21. Passport Number Travel Document NumberForm I-589 (Rev. 04/09/19) NOTE: Check this box if you also want to apply for withholding of removal under the Convention Against Torture. () Date Status Expires 22. Expiration Date (mm/dd/yyyy) In Care Of (if applicable): U.S. Department of Justice Executive Office for Immigration ReviewOMB No. 1615-0067; Expires 05/31/2019I-589, Application for Asylum and for Withholding of Removal 23. What is your native language (include dialect, if applicable)? 24. Are you fluent in English? Yes No 25. What other languages do you speak fluently? 3. USCIS Online Account Number (if any) For EOIR use only.For USCIS use only.Action:Decision: Asylum Officer ID No.: Approval Date: Denial Date: Referral Date: Interview Date: American LegalNet, Inc. www.FormsWorkFlow.com 24. If in the U.S., is your spouse to be included in this application? (Check the appropriate box.) 15. Is this person in the U.S.? 14. Gender 1. Alien Registration Number (A-Number) (if any) 5. Complete Last Name 9. Date of Marriage (mm/dd/yyyy) 12. Nationality (Citizenship) 16. Place of last entry into the U.S. 20. What is your spouse's current status? 2. Passport/ID Card Number (if any) 3. Date of Birth (mm/dd/yyyy) 4. U.S. Social Security Number (if any) 6. First Name 7. Middle Name 8. Other names used (include maiden name and aliases) 10. Place of Marriage 11. City and Country of Birth 13. Race, Ethnic, or Tribal Group Male Female No (Specify location): 17. Date of last entry into the U.S. (mm/dd/yyyy) 18. I-94 Number (if any) 19. Status when last admitted (Visa type, if any) 21. What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy) 23. If previously in the U.S., date of previous arrival (mm/dd/yyyy) 22. Is your spouse in Immigration Court proceedings? Yes No Yes (Attach one photograph of your spouse in the upper right corner of Page 9 on the extra copy of the application submitted for this person.) No Yes (Complete Blocks 16 to 24.) I am not married. (Skip to Your Children below.)Your Children. List all of your children, regardless of age, location, or marital status. I have children. Total number of children:. (NOTE: Use Form I-589 Supplement A or attach additional sheets of paper and documentation if you have more than four children.)Form I-589 (Rev. 04/09/19) Page 2 Your spouse Part A.II. Information About Your Spouse and Children 13. Is this child in the U.S. ? 5. Complete Last Name 9. City and Country of Birth 6. First Name 7. Middle Name 8. Date of Birth (mm/dd/yyyy) 10. Nationality (Citizenship) 11. Race, Ethnic, or Tribal Group 12. Gender 14. Place of last entry into the U.S. 15. Date of last entry into the U.S. (mm/dd/yyyy) 16. I-94 Number (If any) 17. Status when last admitted (Visa type, if any) 18. What is your child's current status? 19. What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy) 20. Is your child in Immigration Court proceedings? 21. If in the U.S., is this child to be included in this application? (Check the appropriate box.) 1. Alien Registration Number (A-Number) (if any) 2. Passport/ID Card Number (if any) 3. Marital Status (Married, Single, Divorced, Widowed) 4. U.S. Social Security Number (if any) Male Female Yes No Yes (Attach one photograph of your child in the upper right corner of Page 9 on the extra copy of the application submitted for this person.) No Yes (Complete Blocks 14 to 21.) No (Specify location): I do not have any children. (Skip to Part. A.III., Information about your background.) American LegalNet, Inc. www.FormsWorkFlow.com Part A.II. Information About Your Spouse and Children (Continued) Form I-589 (Rev. 04/09/19) Page 3 13. Is this child in the U.S. ? 5. Complete Last Name 9. City and Country of Birth 6. First Name 7. Middle Name 8. Date of Birth (mm/dd/yyyy) 10. Nationality (Citizenship) 12. Gender 14. Place of last entry into the U.S. 15. Date of last entry into the U.S. (mm/dd/yyyy) 16. I-94 Number (If any) 17. Status when last admitted (Visa type, if any) 18. What is your child's current status? 19. What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy) 20. Is your child in Immigration Court proceedings? 21. If in the U.S., is this child to be included in this application? (Check the appropriate box.) Yes No Yes (Attach one photograph of your spouse in the upper right corner of Page 9 on the extra copy of the application submitted for this person.) No 1. Alien Registration Number (A-Number) (if any) 2. Passport/ID Card Number (if any) 3. Marital Status (Married, Single, Divorced, Widowed) 4. U.S. Social Security Number (if any) Male Female 13. Is this child in the U.S. ? 5. Complete Last Name 9. City and Country of Birth 6. First Name 7. Middle Name 8. Date of Birth (mm/dd/yyyy) 10. Nationality (Citizenship) 11. Race, Ethnic, or Tribal Group 12. Gender 14. Place of last entry into the U.S. 15. Date of last entry into the U.S. (mm/dd/yyyy) 16. I-94 Number (If any) 17. Status when last admitted (Visa type, if any) 18. What is your child's current status? 19. What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy) 20. Is your child in Immigration Court proceedings? 21. If in the U.S., is this child to be included in this application? (Check the appropriate box.) 1. Alien Registration Number (A-Number) (if any) 2. Passport/ID Card Number (if any) 3. Marital Status (Married, Single, Divorced, Widowed) 4. U.S. Social Security Number (if any) Male Female Yes No Yes (Attach one photograph of your spouse in the upper right corner of Page 9 on the extra copy of the application submitted for this person.) No 13. Is this child in the U.S. ? 5. Complete Last Name 9. City and Country of Birth 6. First Name 7. Middle Name 8. Date of Birth (mm/dd/yyyy) 10. Nationality (Citizenship) 11. Race, Ethnic, or Tribal Group 12. Gender 14. Place of last entry into the U.S. 15. Date of last entry into the U.S. (mm/dd/yyyy) 16. I-94 Number (If any) 17. Status when last admitted (Visa type, if any) 18. What is your child's current status? 19. What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy) 20. Is your child in Immigration Court proceedings? 21. If in the U.S., is this child to be included in this application? (Check the appropriate box.) 1. Alien Registration Number (A-Number) (if any) 2. Passport/ID Card Number (if any) 3. Marital Status (Married, Single, Divorced, Widowed) 4. U.S. Social Security Number (if any) Male Female Yes No Yes (Attach one photograph