POLITICAL ASYLUM
Phone number:
First Name Last Name:
Your email:
Did you come on a tourist (student) visa or via Mexico?
YES
NO
Are you located in the United States?
YES
NO
You are seeking asylum from the US Government because you are being persecuted based on:
-Race
-Religion
-Nationality
-Political opinion
-Membership in a particular social group
-Torture Convention
Have you, your family, or close friends or colleagues ever experienced harm or mistreatment or threats in the past by anyone? Describe in broad strokes without delving into details.
YES
NO
Do you fear harm or mistreatment if you return to your home country? Describe in broad strokes without delving into details.
YES
NO
Are you afraid of being subjected to torture in your home country or any other country to which you may be returned? Describe in broad strokes without delving into details.
YES
NO
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, guerilla organization, ethnic group, human rights group, or the press or media? Please describe in broad strokes without delving into details.
YES
NO
Do you or your family members continue to participate in any way in these organizations or groups? Please describe in broad strokes without delving into details.
YES
NO
Have you or your family members ever been accused, charged, arrested, detained, interrogated, convicted and sentenced, or imprisoned in any country other than the United States (including for an immigration law violation)? Please describe in broad strokes without delving into details.
YES
NO
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 (including for an immigration law violation)? Please describe in broad strokes without delving into details.
YES
NO
Have you, your spouse or child(ren), your parents or your siblings ever applied to the U.S. Government for refugee status, asylum, or withholding of removal? Please describe in broad strokes without delving into details.
YES
NO
Are you filing this application more than 1 year after your last arrival in the United States?
YES
NO
Have you, your spouse or 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? Please describe in broad strokes without delving into details.
YES
NO
Can you provide any evidence to support your claims of persecution or harm inflicted upon you?
YES
NO
Through which countries did your journey to the USA pass?
After you left the country where you were harmed or fear harm, did you return to that country? Please describe in broad strokes without delving into details.
YES
NO
Have you, your spouse or 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? Please describe in broad strokes without delving into details.
YES
NO
Please fill in all required fields/Por favor, rellene todos los campos obligatorios/Пожалуйста, заполните все обязательные поля
Submit
Please fill in all required fields/Por favor, rellene todos los campos obligatorios/Пожалуйста, заполните все обязательные поля
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