HOW TO APPLY FOR ASYLUM - The Florence Project
HOW TO APPLY FOR ASYLUM - The Florence Project
HOW TO APPLY FOR ASYLUM - The Florence Project
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Documentation Request Form<br />
Please fill out all sections and write neatly. Send this form to one of the organizations listed on the<br />
Organizations page. It will be helpful if you also send your asylum application (I-589), letters or forms<br />
that explain your case. <strong>The</strong>se are for internal use only to help document your asylum claim. This<br />
information will not be shared with any other organization, DHS or any other governmental agency<br />
without your prior written consent.<br />
NAME:___________________________________________ A#:__________________________________<br />
ADDRESS:__(address where you want the information sent)________________________________________________<br />
CITY:_________________________ STATE:________________ZIP CODE: _______________________<br />
<strong>TO</strong>DAY’S DATE:____________________DATE OF YOUR HEARING/APPEAL:___________________<br />
PLEASE LIST ALL OF THE ORGANIZATIONS YOU HAVE CONTACTED:______________________<br />
_______________________________________________________________________________________<br />
YOUR CITY/<strong>TO</strong>WN, STATE, AND COUNTRY OF ORIGIN:____________________________________<br />
YEAR OF ARRIVAL IN UNITED STATES: _________________________________________________<br />
PLEASE CIRCLE AND ANSWER ALL THAT <strong>APPLY</strong>:<br />
1. ARE YOU OR WERE YOU A MEMBER OF A PERSECUTED POLITICAL ORGANIZATION YES NO<br />
IF YES, PLEASE LIST ORGANIZATION:___________________________________________________________<br />
2. ARE YOU OR WERE YOU A MEMBER OF A PERSECUTED TRADE UNION YES NO<br />
IF YES, PLEASE LIST NAME OF ORGANIZATION:_________________________________________________<br />
3. ARE YOU OR WERE YOU A MEMBER OF A PERSECUTED CHURCH OR RELIGION YES NO<br />
IF YES, PLEASE LIST RELIGION AND/OR CHURCH:________________________________________________<br />
4. ARE YOU OR WERE YOU A MEMBER OF A PERSECUTED ETHNIC MINORITY YES NO<br />
IF YES, PLEASE LIST ETHNICITY: _______________________________________________________________<br />
5. IS YOUR CLAIM BASED ON SEXUAL ORIENTATION (BECAUSE YOU ARE GAY, LESBIAN, BISEXUAL,<br />
OR TRANSGENDERED) YES NO<br />
6. WERE YOU PERSECUTED BY THE GOVERNMENT OR GOVERNMENT MEMBERS YES NO<br />
IF YES, LIST GROUP:___________________________________________________________________________<br />
7. WERE YOU PERSECUTED BY AN ORGANIZATION/PERSONS OUTSIDE GOVERNMENT YES NO<br />
IF YES, LIST GROUP:___________________________________________________________________________<br />
8. IS YOUR CLAIM BASED ON PERSECUTION BECAUSE OF YOUR GENDER YES NO<br />
Page 43 of 49<br />
FIRRP- last update June 2007