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Part D. Your Signature
Daytime Telephone Number
I certify, under penalty of perjury under the laws of the United States of America, that this application and the evidence submitted with it are all true
and correct. Title 18, United States Code, Section 1546(a), provides in part: Whoever knowingly makes under oath, or as permitted under penalty of
perjury under Section 1746 of Title 28, United States Code, knowingly subscribes as true, any false statement with respect to a material fact in any
application, affidavit, or other document required by the immigration laws or regulations prescribed thereunder, or knowingly presents any such
application, affidavit, or other document containing any such false statement or which fails to contain any reasonable basis in law or fact - shall be
fined in accordance with this title or imprisoned for up to 25 years. I certify that I am physically present in the United States or seeking admission at
a Port of Entry when I execute this application. I authorize the release of any information from my immigration record that U.S. Citizenship and
Immigration Services (USCIS) needs to determine eligibility for the benefit I am seeking.
WARNING: Applicants who are in the United States unlawfully are subject to removal if their asylum or withholding claims are not
granted by an asylum officer or an immigration judge. Any information provided in completing this application may be used as a basis for
the institution of, or as evidence in, removal proceedings even if the application is later withdrawn, and even if USCIS does not conduct an
interview on the application. Applicants determined to have knowingly made a frivolous application for asylum will be permanently
ineligible for any benefits under the Immigration and Nationality Act. You may not avoid a frivolous finding simply because someone
advised you to provide false information in your asylum application. If filing with USCIS, unexcused failure to appear for an appointment
to provide biometrics (such as fingerprints) and your biographical information within the time allowed may result in an asylum officer
dismissing your asylum application or referring it to an immigration judge. Failure without good cause to provide DHS with biometrics or
other biographical information while in removal proceedings may result in your application being found abandoned by the immigration
judge. See sections 208(d)(5)(A) and 208(d)(6) of the INA and 8 CFR sections 208.10, 1208.10, 208.20, 1003.47(d) and 1208.20.
Print your complete name. Write your name in your native alphabet.
Did your spouse, parent, or child(ren) assist you in completing this application?
Yes (If "Yes," list the name and relationship.)
(Name) (Relationship) (Name) (Relationship)
Did someone other than your spouse, parent, or child(ren) prepare this application?
Yes (If "Yes,"complete Part E.)
Asylum applicants may be represented by counsel. Have you been provided with a list of
persons who may be available to assist you, at little or no cost, with your asylum claim?
Yes
Signature of Applicant (The person in Part. A.I.)
Sign your name so it all appears within the brackets
[ ]
Part E. Declaration of Person Preparing Form, if Other Than Applicant, Spouse, Parent, or Child
I declare that I have prepared this application at the request of the person named in Part D, that the responses provided are based on all information of
which I have knowledge, or which was provided to me by the applicant, and that the completed application was read to the applicant in his or her
native language or a language he or she understands for verification before he or she signed the application in my presence. I am aware that the
knowing placement of false information on the Form I-589 may also subject me to civil penalties under 8 U.S.C. 1324c and/or criminal penalties
under 18 U.S.C. 1546(a).
Signature of Preparer Print Complete Name of Preparer
Apt. Number City State Zip Code
Address of Preparer: Street Number and Name
)(
No
No
No
Attorney State Bar Number (if
applicable)
Select this box if
Form G-28 is
attached.
Attorney or Accredited Representative
USCIS Online Account Number (if any)
To be completed by an
attorney or accredited
representative (if any).
Date (mm/dd/yyyy)
Form I-589 Edition 07/28/26