Free template
I-589 Application for Asylum and for Withholding of Removal Personal Statement Template
Tell your asylum story in a clear, structured declaration to support your I-589 application.
Downloaded 2874 times
I-589 Application for Asylum and for Withholding of Removal Personal Statement Template
Download template
I-589 Application for Asylum and for Withholding of Removal Personal Statement Template
[Your Full Name]
[A-Number (if any)]
[Your Street Address]
[City, State, ZIP Code]
[Phone Number]
[Email Address]
[Date]
U.S. Citizenship and Immigration Services
[USCIS Asylum Office Address or Other Address]
Re: Form I-589, Application for Asylum and for Withholding of Removal
Personal Statement of [Your Full Name], DOB: [MM/DD/YYYY]
1. Introduction and Purpose of This Statement
I, [Your Full Name], was born on [Date of Birth] in [City, Country]. I am submitting this personal statement in support of my Form I-589, Application for Asylum and for Withholding of Removal.
In this statement, I describe my background, the events that caused me to flee [Country], the harm I have suffered, my fear of returning, and the reasons I seek protection in the United States.
2. Personal Background
Full Name: [Your Full Name]
Date of Birth: [MM/DD/YYYY]
Place of Birth: [City, Country]
Citizenship/Nationality: [Country]
Ethnic Group (if applicable): [Ethnic Group or “N/A”]
Religion or Belief System (if applicable): [Religion / Belief or “N/A”]
Primary Language(s): [Language(s)]
Education: [Highest Level of Education, Schools Attended, Years]
Occupation in Home Country: [Job Title / Work History]
Brief Description of Early Life:
[Short paragraph describing your family situation, community, and important aspects of your life before problems began.]
3. Family Background and Dependents
Parents:
[Parent’s Name], [Date of Birth], [Status / Location]
[Parent’s Name], [Date of Birth], [Status / Location]
Spouse or Partner (if any):
Name: [Spouse/Partner Name]
Date of Birth: [MM/DD/YYYY]
Citizenship/Nationality: [Country]
Current Location and Status: [Location / Status]
Children (if any):
[Child’s Name], DOB: [MM/DD/YYYY], [Country of Birth], [Current Location and Status]
[Child’s Name], DOB: [MM/DD/YYYY], [Country of Birth], [Current Location and Status]
Other Close Family Members:
[Names, relationships, and current locations of siblings, grandparents, or other important relatives.]
4. Political, Religious, Social, or Other Identity
Political Opinion or Activities (if relevant):
[Description of any political opinions, memberships, voting, activism, party involvement, or public positions.]
Religion or Religious Activities (if relevant):
[Description of your religion, religious practices, religious community membership, or any issues related to religion.]
Membership in a Particular Social Group (if relevant):
[Description of social group, such as family, gender, sexual orientation, profession, or other defining characteristic.]
Other Important Characteristics:
[Any other identity or characteristic that is connected to the harm you suffered or fear, such as ethnicity, tribe, region, or social role.]
5. Entry to the United States and Immigration History
Date of Last Departure from Home Country: [Date]
Route of Travel: [Countries and Transit Points]
Date of Arrival in the United States: [Date]
Place of Arrival: [City, State or Port of Entry]
Manner of Entry: [With Visa / Without Inspection / Other]
Class of Admission (if any): [Class of Admission or “N/A”]
Prior Immigration Applications or Proceedings in the United States:
[Description of any prior applications, removal proceedings, or other immigration history, or “None”.]
6. Events Leading Up to the Harm or Threats
Background Conditions in Home Country:
[Brief description of conditions in your region or country that are relevant to your case, such as conflict, political situation, or persecution of certain groups.]
Timeline Before the Harm Began:
[Description of your life, work, or activities leading up to the first incident, including any political, religious, social, or personal developments that are connected to later harm.]
7. Past Harm, Threats, or Persecution
First Major Incident:
Date: [Approximate Date or Time Period]
Place: [City/Town, Region, Country]
People or Groups Involved: [Names, Groups, or Descriptions]
What Happened:
[Detailed description of threats, violence, arrest, detention, harassment, or other harm.]Reason You Believe It Happened:
[Connection to political opinion, religion, ethnicity, social group, or other protected ground.]
Second Major Incident (if any):
Date: [Approximate Date or Time Period]
Place: [City/Town, Region, Country]
People or Groups Involved: [Names, Groups, or Descriptions]
What Happened:
[Detailed description of threats, violence, arrest, detention, harassment, or other harm.]Reason You Believe It Happened:
[Connection to political opinion, religion, ethnicity, social group, or other protected ground.]
Additional Incidents or Ongoing Harassment:
[Description of any repeated threats, surveillance, harassment, discrimination, or other harm, with approximate dates and locations.]
8. Detention, Arrest, or Serious Mistreatment (if applicable)
Dates of Arrest or Detention: [Dates or Time Periods]
Places of Detention: [Locations]
Authorities or Groups Responsible: [Police, Military, Militia, Organization, Other]
Description of Treatment:
[Description of interrogation, physical violence, psychological abuse, torture, forced labor, or other serious mistreatment.]
Injuries or Medical Consequences:
[Description of physical injuries, medical treatment received or not received, and any lasting effects.]
9. Attempts to Get Help or Protection
Authorities or Organizations Contacted:
[Police, government offices, courts, human rights groups, NGOs, community leaders, or others you asked for help.]
Responses Received:
[Description of what was done, not done, or said to you when you requested help or protection.]
Results of Attempts:
[Description of whether the harm continued, worsened, or stopped, and any reasons you believe the authorities could not or would not protect you.]
10. Continued Threats and Fear of Return
Current Situation in Home Country:
[Description of current conditions, including whether the people or groups who harmed or threatened you still have power or influence.]
Ongoing Threats or Interest in You:
[Description of any recent messages, visits, calls, or actions targeting you or your family, even after you left.]
Reasons You Are Afraid to Return:
[Explanation of what you believe would happen if you were forced to return, who would harm you, why they would target you, and how this is connected to your political opinion, religion, ethnicity, social group, or other protected ground.]
11. Ability to Relocate Within Home Country
Possibility of Relocation to Another Area:
[Explanation of whether you could safely live in another part of your country, and any reasons this is not safe, reasonable, or possible for you or your family.]
Family, Community, or Support in Other Areas:
[Description of whether you have any realistic support network in other regions of your country.]
12. Other Relevant Information
Criminal History (if any):
[Description of any criminal charges, arrests, or convictions in any country, or “I have never been arrested or convicted of a crime in any country.”]
Military Service or Armed Group Involvement (if any):
[Description of any military service, conscription, or contact with armed groups, or “None”.]
Travel to Other Countries:
[Description of significant prior stays in other countries and whether you sought protection there, or “None”.]
Any Other Information Relevant to Your Claim:
[Additional facts that help explain your story, your character, your family responsibilities, or your need for protection.]
13. Impact of the Events on Your Life
Physical Effects:
[Description of ongoing physical health problems, injuries, or disabilities resulting from past harm.]
Emotional and Psychological Effects:
[Description of fear, anxiety, depression, nightmares, or other emotional or psychological impacts, including any counseling or treatment.]
Effects on Family Life, Work, and Daily Living:
[Description of how the events and your fear have changed your family relationships, ability to work, study, or live normally.]
14. Closing Declaration
I respectfully request asylum, withholding of removal, and any other available protection in the United States. I am afraid to return to [Country] because of the harm I have suffered and the serious risk of harm I face there in the future.
I declare under penalty of perjury under the laws of the United States of America that the information in this statement and in my Form I-589 is true and correct to the best of my knowledge and belief.
Executed on [Day] [Month], [Year], in [City, State].
[Your Full Name]
[Signature, if printed]
[Date]
Flash deal
Flash deal
Today
Today
No time to fill it up? Generate your custom agreement with AI Lawyer in seconds
What’s Included
Legal Research
Legal Research
Legal Research
Contract Drafting
Contract Drafting
Contract Drafting
Document Review
Document Review
Document Review
Risk Analytics
Risk Analytics
Risk Analytics
Citation Verification
Citation Verification
Citation Verification
Easy-to-understand jargon
Easy-to-understand jargon
Easy-to-understand jargon
Details
Learn more about
I-589 Application for Asylum and for Withholding of Removal Personal Statement Template
Click below for detailed info on the template.
For quick answers, scroll below to see the FAQ.
Click below for detailed info on the template.
For quick answers, scroll below to see the FAQ.
I-589 APPLICATION FOR ASYLUM AND FOR WITHHOLDING OF REMOVAL TEMPLATE FAQ
What is Form I-589, Application for Asylum and for Withholding of Removal?
Form I-589 is the official immigration form used by individuals who are physically present in the United States and seeking protection as refugees. It is used to request asylum and, in many cases, to request withholding of removal in the same application.
What is an I-589 personal statement or asylum declaration?
An I-589 personal statement (sometimes called an asylum declaration) is a written document where you tell your story in your own words. It usually explains who you are, what happened to you in the past, why you are afraid to return to your country, and how this relates to protected grounds such as your race, religion, nationality, political opinion, or membership in a particular social group. It is meant to support the answers you give on Form I-589, not replace the form itself.
What should I include in an I-589 asylum personal statement?
In an I-589 asylum personal statement, you generally describe: your personal background; important details about your identity (such as your ethnicity, religion, political views, or other characteristics); specific incidents of harm, threats, or persecution; who harmed you and why; your fears if you return; why you could not be safe in another part of your country; and any supporting evidence or witnesses. The statement should be honest, detailed, and consistent with the information in your I-589 and other documents.
How long should an I-589 asylum personal statement be?
There is no fixed rule for length, but many effective asylum declarations are between three and ten pages, depending on how complex the story is. It should be long enough to clearly describe what happened, why you are afraid, and how this affects you, but not so long that it becomes confusing or repetitive. Clear structure, specific examples, and truthful details are more important than the exact number of pages.
Does this I-589 template replace legal advice or official instructions?
No. This template is only a sample format to help you organize your thoughts and write your own personal statement. It does not replace the official Form I-589, the official instructions, or advice from a qualified immigration attorney or accredited representative. Asylum and withholding of removal are complex legal processes, and small details can matter a lot. Whenever possible, you should have your application and declaration reviewed by a legal professional before filing.
Can AI Lawyer help me write my asylum personal statement?
Yes. AI Lawyer can help you use this I-589 template by suggesting clear wording, improving structure, and helping you tell your story in a more organized and readable way. You still need to provide the true facts, documents, and decisions about what to include. AI Lawyer does not replace a licensed immigration attorney and does not provide legal advice or guarantee any outcome, but it can save time, reduce stress, and help you create a more polished draft to review with a qualified professional.
Similar templates
Other templates from
Letters and Notices Templates
Money back guarantee
Free trial
Cancel anytime
AI Lawyer protects
your rights and wallet
Money back guarantee
Free trial
Cancel anytime
AI Lawyer protects
your rights and wallet
Money back guarantee
Free trial
Cancel anytime
AI Lawyer protects
your rights and wallet
Money back guarantee
Free trial
Cancel anytime