G-325A, Biographic Information (for Deferred Action) Family NameFirst NameFile NumberCitizenship/NationalityMiddle NameDate of Birth (mm/dd/yyyy)AOMB No. 1615-0008; Expires 10/31/2019Department of Homeland Security U.S. Citizenship and Immigration Services All Other Names Used (include names by previous marriages)U.S. Social Security No. (if any) City and Country of Birth Family NameFirst NameCity, and Country of Birth(if known)FatherMother (Maiden Name)City and Country of Residence Current Husband or Wife (If none, so state) Family Name (For wife, give maiden name)Date of Birth (mm/dd/yyyy)First NameCity and Country of BirthDate of MarriagePlace of Marriage Applicant's residence last five years. List present address first. Street Name and Number City Province or State Country From Month Year 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 Country From Month Year To Month Year Full Name and Address of Employer Occupation (Specify) From Month Year To Month Year Present Time Applicant's employment last five years. (If none, so state.) List present employment first. If your native alphabet is in other than Roman letters, write your name in your native alphabet below:Last occupation abroad if not shown above. (Include all information requested above.) This form is submitted in connection with an application for: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.(Alien Registration Number)Complete This Box (Family Name)(Middle Name)(Given Name)DateSignature of Applicant NaturalizationOther (Specify):Status as Permanent Resident Form G-325A (Rev. 03/29/18) First NameDate of Birth (mm/dd/yyyy)Date and Place of MarriageDate and Place of Termination of MarriageFormer Husbands or Wives (If none, so state)Family Name (For wife, give maiden name) Female Male Date of Birth (mm/dd/yyyy)A InstructionsUSCIS will use the information you provide on this form to process your application or petition. 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. Form G-325A (Rev. 03/29/18) Page 2 What Is the Purpose of This Form?PURPOSE: The primary purpose for providing the requested information on this form is to determine eligibility of discretionary deferred action on a case-by-case basis, for certain family members of military personnel, military personnel who previously served, and Delayed Entry Program enlistees. The Department of Homeland Security (DHS) will use the information you provide to grant or deny the immigration benefit you are seeking. USCIS Privacy Act Statement Paperwork Reduction ActAn 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 for reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Avenue, NW, Washington, DC 20529-2140, OMB No. 1615-0008. Do not mail your completed Form G-325A to this address.Complete this biographical information form and include it with the application or petition you are submitting to U.S. Citizenship and Immigration Services (USCIS).DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and any requested evidence, may delay the naturalization process. ROUTINE USES: DHS may share the information you provide on this form 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-007 - Benefits Information System, October 19, 2016, 81 FR 72069 and DHS/USCIS/ICE/CBP-001 - Alien File, Index, and National File Tracking System of Records, November 21, 2013, 78 FR 69864 (A-File)] which you can find at www.dhs.gov/privacy. DHS may also share the information, as appropriate, for law enforcement purposes or in the interest of national security.AUTHORITIES: The information requested on this benefit application, and the associated evidence, is collected under the Immigration and Nationality Act (INA) section 103 and 8 U.S.C. 1103(a)(1), which gives the Secretary of Homeland Security (the Secretary) general authority to enforce and administer the immigration laws.