I-589 Blank
I-589 Blank
9. Gender: Male Female 10. Marital Status: Single Married Divorced Widowed
11. Date of Birth (mm/dd/yyyy) 12. City and Country of Birth
06/01/1988 YANGON(RANGOON),MYANMAR(BURMA)
13. Present Nationality (Citizenship) 14. Nationality at Birth 15. Race, Ethnic, or Tribal Group 16. Religion
MYANMAR(BURMESE) MYANMAR(BURMA) BURMESE BUDDHIST
17. Check the box, a through c, that applies:a. I have never been in Immigration Court proceedings.
b. I am now in Immigration Court proceedings. c. I am not now in Immigration Court proceedings, but I have been in the past.
18. Complete 18 a through c.
a. When did you last leave your country? (mmm/dd/yyyy) 02/03/2011 b. What is your current I-94 Number, if any? 85422603923
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.)
22. What is your native language 23. Are you fluent in English? 24. What other languages do you speak fluently?
(include dialect, if applicable)? Yes No
BURMESE Action: For USCIS use only. Decision:
For EOIR use only. Approval Date:
Interview Date:
Denial Date:
Asylum Officer ID#:
Referral Date:
Form I-589 (Rev. 04/07/09) Y
Part A. II. Information About Your Spouse and Children
Your spouse I am not married. (Skip to Your Children below.)
1. Alien Registration Number (A-Number) 2. Passport/ID Card No. 3. Date of Birth 4. U.S. Social Security No. (if any)
(if any) (if any) (mm/dd/yyyy)
NONE 12/MAGATA(NAING)088625 10/10/87
5. Complete Last Name 6. First Name 7. Middle Name 8. Maiden Name
WIN SANDAR SOE
9. Date of Marriage (mm/dd/yyyy) 10. Place of Marriage 11. City and Country of Birth
01/31/11 TAMWE TS COURT,YANGON YANGON(RANGOON),MYANMAR(BURMA)
12. Nationality (Citizenship) 13. Race, Ethnic, or Tribal Group 14. Gender
MYANMAR(BURMA) CHINESE+BURMESE Male Female
15. Is this person in the U.S.?
Yes (Complete Blocks 16 to 24.) No (Specify location): NO.50,101 STREET,PHOT-MYAY WARD,MINGALARTAUNGNYUNT
16. Place of last entry into the U.S. 17. Date of last entry into the 18. I-94 No. (if any) 19. Status when last admitted
U.S. (mm/dd/yyyy) (Visa type, if any)
20. What is your spouse's 21. What is the expiration date of his/her 22. Is your spouse in Immigration 23. If previously in the U.S., date of
current status? authorized stay, if any? (mm/dd/yyyy) Court proceedings? previous arrival (mm/dd/yyyy)
Yes No
24. If in the U.S., is your spouse to be included in this application? (Check the appropriate box.)
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
Your Children. List all of your children, regardless of age, location, or marital status.
I do not have any children. (Skip to Part A. III., Information about your background.)
1. Alien Registration Number (A-Number) 2. Passport/ID Card No. (if any) 3. Marital Status (Married, Single, 4. U.S. Social Security No.
(if any) Divorced, Widowed) (if any)
5. Complete Last Name 6. First Name 7. Middle Name 8. Date of Birth (mm/dd/yyyy)
9. City and Country of Birth 10. Nationality (Citizenship) 11. Race, Ethnic, or Tribal Group 12. Gender
Male Female
13. Is this child in the U.S. ?
Yes (Complete Blocks 14 to 21.) No (Specify location.)
14. Place of last entry in the U.S. 15. Date of last entry in the 16. I-94 No. (if any) 17. Status when last admitted
U.S. (mm/dd/yyyy) (Visa type, if any)
21. If in the U.S., is this child to be included in this application? (Check the appropriate box.)
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
5. Complete Last Name 6. First Name 7. Middle Name 8. Date of Birth (mm/dd/yyyy)
9. City and Country of Birth 10. Nationality (Citizenship) 11. Race, Ethnic, or Tribal Group 12. Gender
Male Female
13. Is this child in the U.S. ?
Yes (Complete Blocks 14 to 21.) No (Specify location.)
14. Place of last entry into the U.S. 15. Date of last entry into the 16. I-94 No. (If any) 17. Status when last admitted
U.S. (mm/dd/yyyy) (Visa type, if any)
21. If in the U.S., is this child to be included in this application? (Check the appropriate box.)
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
1. Alien Registration Number (A-Number) 2. Passport/ID Card No. (if any) 3. Marital Status (Married, Single, 4. U.S. Social Security No.
(if any) Divorced, Widowed) (if any)
5. Complete Last Name 6. First Name 7. Middle Name 8. Date of Birth (mm/dd/yyyy)
9. City and Country of Birth 10. Nationality (Citizenship) 11. Race, Ethnic, or Tribal Group 12. Gender
Male Female
13. Is this child in the U.S.?
Yes (Complete Blocks 14 to 21.) No (Specify location.)
14. Place of last entry into the U.S. 15. Date of last entry into the 16. I-94 No. (If any) 17. Status when last admitted
U.S. (mm/dd/yyyy) (Visa type, if any)
21. If in the U.S., is this child to be included in this application? (Check the appropriate box.)
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
1. Alien Registration Number (A-Number) 2. Passport/ID Card No. (if any) 3. Marital Status (Married, Single, 4. U.S. Social Security No.
(if any) Divorced, Widowed) (if any)
5. Complete Last Name 6. First Name 7. Middle Name 8. Date of Birth (mm/dd/yyyy)
9. City and Country of Birth 10. Nationality (Citizenship) 11. Race, Ethnic, or Tribal Group 12. Gender
Male Female
13. Is this child in the U.S. ?
Yes (Complete Blocks 14 to 21.) No (Specify location.)
14. Place of last entry into the U.S. 15. Date of last entry into the 16. I-94 No. (if any) 17. Status when last admitted
U.S. (mm/dd/yyyy) (Visa type, if any)
21. If in the U.S., is this child to be included in this application? (Check the appropriate box.)
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
Form I-589 (Rev. 04/07/09) Y Page 3
Part A. III. Information About Your Background
1. List your last address where you lived before coming to the United States. If this is not the country where you fear persecution, also list the last
address in the country where you fear persecution. (List Address, City/Town, Department, Province, or State and Country.)
(NOTE: Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)
Number and Street Dates
City/Town Department, Province, or State Country
(Provide if available) From (Mo/Yr) To (Mo/Yr)
NO.9,105 STREET MINGALATUNGNYUNTYANGON(RANGOON) MYANMAR(BURMA) 06/88 02/11
2. Provide the following information about your residences during the past 5 years. List your present address first.
(NOTE: Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)
Dates
Number and Street City/Town Department, Province, or State Country
From (Mo/Yr) To (Mo/Yr)
NO.9,105 STREET MINGALATUNGNYUNTYANGON(RANGOON) MYANMAR(BURMA) *00/92 02/11
3. Provide the following information about your education, beginning with the most recent.
(NOTE: Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)
Attended
Name of School Type of School Location (Address)
From (Mo/Yr) To (Mo/Yr)
NO.6,BASIC HIGH SCHOOL BOTATAUNGSTATE BOTATAUNG TOWNSHIP,YANGON(RANGOON),MYANMAR(BURAM
06/94 03/04
4. Provide the following information about your employment during the past 5 years. List your present employment first.
(NOTE: Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)
Dates
Name and Address of Employer Your Occupation
From (Mo/Yr) To (Mo/Yr)
PADAUK PWINT THIT MAGAZINE JOB TRAINEE 01/09 03/10
5. Provide the following information about your parents and siblings (brothers and sisters). Check the box if the person is deceased.
(NOTE: Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)
Full Name City/Town and Country of Birth Current Location
Sibling Deceased
Sibling Deceased
Sibling Deceased
Sibling Deceased
Refer to Instructions, Part 1: Filing Instructions, Section II, "Basis of Eligibility," Parts A - D, Section V, "Completing the Form," Part B, and
Section VII, "Additional Evidence That You Should Submit," for more information on completing this section of the form.
1. Why are you applying for asylum or withholding of removal under section 241(b)(3) of the INA, or for withholding of removal under the
Convention Against Torture? Check the appropriate box(es) below and then provide detailed answers to questions A and B below:
A. Have you, your family, or close friends or colleagues ever experienced harm or mistreatment or threats in the past by anyone?
No Yes
No Yes
If "Yes," explain in detail:
1. What harm or mistreatment you fear;
2. Who you believe would harm or mistreat you; and
3. Why you believe you would or could be harmed or mistreated.
No Yes
If "Yes," explain the circumstances and reasons for the action.
3.A. Have you or your family members ever belonged to or been associated with any organizations or groups in your home country, such
as, but not limited to, a political party, student group, labor union, religious organization, military or paramilitary group, civil patrol,
guerrilla organization, ethnic group, human rights group, or the press or media?
No Yes
If "Yes," describe for each person the level of participation, any leadership or other positions held, and the length of time you or your
family members were involved in each organization or activity.
B. Do you or your family members continue to participate in any way in these organizations or groups?
No Yes
If "Yes," describe for each person your or your family members' current level of participation, any leadership or other positions currently
held, and the length of time you or your family members have been involved in each organization or group.
4. Are you afraid of being subjected to torture in your home country or any other country to which you may be returned?
No Yes
If "Yes," explain why you are afraid and describe the nature of torture you fear, by whom, and why it would be inflicted.
2. A. After leaving the country from which you are claiming asylum, did you or your spouse or child(ren) who are now in the United States travel
through or reside in any other country before entering the United States? No Yes
B. Have you, your spouse, your child(ren), or other family members, such as your parents or siblings, ever applied for or received any lawful
status in any country other than the one from which you are now claiming asylum?
No Yes
If "Yes" to either or both questions (2A and/or 2B), provide for each person the following: the name of each country and the length of stay,
the person's status while there, the reasons for leaving, whether or not the person is entitled to return for lawful residence purposes, and
whether the person applied for refugee status or for asylum while there, and if not, why he or she did not do so.
3. Have you, your spouse or your child(ren) ever ordered, incited, assisted or otherwise participated in causing harm or suffering to any person
because of his or her race, religion, nationality, membership in a particular social group or belief in a particular political opinion?
No Yes
If "Yes," describe in detail each such incident and your own, your spouse's, or your child(ren)'s involvement.
5. Are you filing this application more than 1 year after your last arrival in the United States?
No Yes
If "Yes," explain why you did not file within the first year after you arrived. You must be prepared to explain at your interview or hearing
why you did not file your asylum application within the first year after you arrived. For guidance in answering this question, see
Instructions, Part 1: Filing Instructions, Section V. "Completing the Form," Part C.
6. Have you or any member of your family included in the application ever committed any crime and/or been arrested, charged,
convicted, or sentenced for any crimes in the United States?
No Yes
If "Yes," for each instance, specify in your response: what occurred and the circumstances, dates, length of sentence received, location, the
duration of the detention or imprisonment, reason(s) for the detention or conviction, any formal charges that were lodged against you or
your relatives included in your application, and the reason(s) for release. Attach documents referring to these incidents, if they are
available, or an explanation of why documents are not available.
WARNING: Applicants who are in the United States illegally 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. 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? No Yes (If "Yes," list the name and relationship.)
[ ]
Sign your name so it all appears within the brackets Date (mm/dd/yyyy)
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).
I swear (affirm) that I know the contents of this application that I am signing, including the attached documents and supplements, that they are
all true or not all true to the best of my knowledge and that correction(s) numbered to were made by me or at my request.
Furthermore, I am aware that if I am determined to have knowingly made a frivolous application for asylum I will be permanently ineligible for any
benefits under the Immigration and Nationality Act, and that I may not avoid a frivolous finding simply because someone advised me to provide
false information in my asylum application.
I swear (affirm) that I know the contents of this application that I am signing, including the attached documents and supplements, that they are
all true or not all true to the best of my knowledge and that correction(s) numbered to were made by me or at my request.
Furthermore, I am aware that if I am determined to have knowingly made a frivolous application for asylum I will be permanently ineligible for any
benefits under the Immigration and Nationality Act, and that I may not avoid a frivolous finding simply because someone advised me to provide
false information in my asylum application.
1. Alien Registration Number 2. Passport/ID Card Number 3. Marital Status (Married, Single, 4. U.S. Social Security Number
(A-Number) (if any) (if any) Divorced, Widowed) (if any)
9. City and Country of Birth 10. Nationality (Citizenship) 11. Race, Ethnic, or Tribal Group 12. Gender
Male Female
13. Is this child in the U.S.? Yes (Complete blocks 14 to 21.) No (Specify location.)
14. Place of last entry into the U.S. 15. Date of last entry into the U.S. 16. I-94 Number (if any) 17. Status when last admitted
(mm/dd/yyyy) (Visa type, if any)
18. What is your child's current 19. What is the expiration date of his/her authorized 20. Is your child in Immigration Court proceedings?
status? stay, if any? (mm/dd/yyyy)
Yes No
21. If in the U.S., is this child to be included in this application? (Check the appropriate box.)
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
1. Alien Registration Number 2. Passport/ID Card Number 3. Marital Status (Married, Single, 4. U.S. Social Security Number
(A-Number) (if any) (if any) Divorced, Widowed) (if any)
9. City and Country of Birth 10. Nationality (Citizenship) 11. Race, Ethnic, or Tribal Group 12. Gender
Male Female
13. Is this child in the U.S.? Yes (Complete blocks 14 to 21.) No (Specify location.)
16. I-94 Number (if any) 17. Status when last admitted
14. Place of last entry into the U.S. 15. (mm/dd/yyyy)
Date of last entry into the U.S.
(Visa type, if any)
18. What is your child's current 19. What is the expiration date of his/her authorized 20. Is your child in Immigration Court proceedings?
status? stay, if any? (mm/dd/yyyy)
Yes No
21. If in the U.S., is this child to be included in this application? (Check the appropriate box.)
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
NOTE: Use this as a continuation page for any additional information requested. Copy and complete as needed.
Part
Question