DISCLAIMER (READ FIRST)
This template is provided for general informational purposes only and does NOT constitute legal advice. Form I-589 is an official U.S. Government form that must be filed on the most current edition available from USCIS/EOIR. The template below is designed to help attorneys assemble the supporting packet that typically accompanies a properly completed Form I-589 (e.g., cover letter, sworn declaration, exhibit index, proof of service, etc.). Always confirm current filing instructions, deadlines, and venue‐specific requirements, and tailor all content to the client’s facts. Consult qualified immigration counsel before relying on or submitting any document derived from this template.
I-589 ASYLUM & WITHHOLDING OF REMOVAL APPLICATION PACKET
(Supporting Materials Template)
[// GUIDANCE: This packet is intended to be placed on top of the duly-executed Form I-589 before filing with either USCIS (affirmative) or the Immigration Court (defensive). Remove any sections that are not required for the client’s circumstances.]
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions (Applicant’s Narrative Statement)
- Representations & Warranties (Sworn Declaration)
- Covenants & Continuing Obligations
- Penalties for False Statements (Notice)
- Risk Allocation & Reservation of Rights
- Dispute Resolution & Governing Law
- General Provisions
- Execution Block
- Addenda
- Index of Exhibits
- Proof of Service
1. DOCUMENT HEADER
Application for Asylum and for Withholding of Removal
Pursuant to Immigration and Nationality Act §§ 208 & 241(b)(3)
Applicant: [APPLICANT LEGAL NAME] (“Applicant”)
Alien Registration No.: [A-NUMBER]
Current Venue: [“USCIS Asylum Office – [City, State]” OR “U.S. Immigration Court – [City, State]”]
Counsel of Record: [LAW FIRM NAME], [ATTORNEY NAME], [BAR NO.]
Date Prepared: [DATE]
Recitals
A. Applicant seeks protection from persecution on account of race, religion, nationality, political opinion, and/or membership in a particular social group as defined in INA § 101(a)(42)(A).
B. Applicant timely files the accompanying Form I-589 and supporting materials in accordance with 8 C.F.R. §§ 208.3 & 1208.3.
2. DEFINITIONS
The following terms, when capitalized, have the meanings set forth below:
- “Application” means the entire packet consisting of the official Form I-589 plus every addendum, exhibit, declaration, and filing submitted herewith.
- “Asylum Office” means the USCIS asylum office having jurisdiction over an affirmative Application.
- “Immigration Court” means the Executive Office for Immigration Review (EOIR) tribunal with jurisdiction over a defensive Application.
- “Nexus” refers to the causal connection between past/future harm and a protected ground under INA § 101(a)(42)(A).
- “Persecution” has the meaning assigned by controlling Board of Immigration Appeals and federal circuit precedent.
- “Protected Ground(s)” means race, religion, nationality, political opinion, or membership in a particular social group.
[// GUIDANCE: Add or delete definitions to fit the theory of the individual case.]
3. OPERATIVE PROVISIONS
3.1 Basis for Relief
- Factual Summary. Applicant is a national of [COUNTRY] who fears persecution by [PERSECUTOR(S)] on account of [PROTECTED GROUND(S)].
- Past Harm. Between [DATE] and [DATE], Applicant was subjected to [DESCRIPTION OF HARM].
- Future Harm. Applicant believes that, if returned to [COUNTRY], [DESCRIBE REASONABLE FEAR AND SPECIFIC THREATS].
- Government Involvement. [DESCRIBE WHETHER PERSECUTION IS BY STATE ACTOR OR WHETHER THE STATE IS UNABLE/UNWILLING TO CONTROL].
- Internal Relocation Analysis. [EXPLAIN WHY INTERNAL RELOCATION IS NOT REASONABLE].
- One-Year Filing Deadline. [STATE COMPLIANCE OR EXCEPTION—e.g., “Application is filed within one year of arrival” OR “extraordinary circumstances” OR “changed circumstances” under 8 C.F.R. § 208.4(a)(5)].
- Bars to Eligibility. [STATE NONE APPLY OR ADDRESS SPECIFIC EXCEPTIONS (e.g., firm resettlement, persecutor bar, crime bar, etc.)].
3.2 Withholding of Removal & CAT Relief (if applicable)
Applicant alternatively seeks withholding of removal under INA § 241(b)(3) and protection under the Convention Against Torture (CAT), 8 C.F.R. §§ 208.16-208.18, and incorporates by reference the above factual allegations.
4. REPRESENTATIONS & WARRANTIES (SWORN DECLARATION)
I, [APPLICANT NAME], declare under penalty of perjury under 28 U.S.C. § 1746 that:
- I am the Applicant identified in this Application, and every statement, fact, and exhibit is true and correct to the best of my knowledge and belief.
- I have reviewed the entirety of this Application, including every translation, and I understand its contents.
- Any omission or error is unintentional and will be corrected promptly upon discovery.
Executed on [DATE] at [CITY, STATE].
[APPLICANT SIGNATURE]
5. COVENANTS & CONTINUING OBLIGATIONS
- Address Updates. Applicant shall provide written notice of any change of address or telephone number within ten (10) days, in compliance with 8 C.F.R. § 265.1.
- Cooperation with Proceedings. Applicant shall appear for biometric capture, interviews, and hearings as scheduled.
- Evidence Preservation. Applicant will preserve all original documents referenced in the Application and make them available upon request.
6. PENALTIES FOR FALSE STATEMENTS (NOTICE)
Applicant acknowledges awareness of the criminal provisions at 18 U.S.C. §§ 1001 & 1546(a) regarding false statements, perjury, and immigration fraud, as well as civil consequences including denial of relief and removal.
7. RISK ALLOCATION & RESERVATION OF RIGHTS
Nothing herein waives any statutory or regulatory right to seek additional or alternative relief, including but not limited to adjustment of status, Temporary Protected Status, or voluntary departure. All rights, claims, and defenses, at law or in equity, are expressly reserved.
8. DISPUTE RESOLUTION & GOVERNING LAW
This Application is governed exclusively by federal immigration law, the Immigration and Nationality Act, Title 8 of the United States Code, and implementing regulations. All adjudication and appellate review shall take place in the administrative fora prescribed by statute (USCIS, EOIR, BIA) and, where applicable, the federal courts of review. Arbitration is not available. Jury trial rights do not apply to removal proceedings, which are administrative in nature. Nothing herein limits the authority of the Immigration Judge or reviewing courts to grant injunctive or equitable relief as permitted by law.
9. GENERAL PROVISIONS
- Amendments. Applicant may amend or supplement this Application at any time before a final decision in accordance with 8 C.F.R. §§ 208.4(b) & 1208.4(c).
- Severability. If any portion of this Application is found unenforceable or immaterial, the remainder shall continue in full force.
- Integration. This packet, together with the official Form I-589 and all exhibits, constitutes the complete submission.
- Counterparts & Electronic Signatures. Copies and electronic signatures shall be deemed originals for filing purposes, except where wet ink is required by regulation or local rule.
10. EXECUTION BLOCK
Prepared by:
[ATTORNEY NAME], Esq.
[LAW FIRM NAME]
[ADDRESS]
[PHONE] | [EMAIL]
Date: [DATE]
Attorney Signature: ______
Applicant Signature: ______
Interpreter (if any): ______
Notary (if required by local rule): ______
11. ADDENDA
11.1 Legal Brief in Support of Eligibility (optional)
11.2 Country-Conditions Expert Report (optional)
11.3 Psychological Evaluation (optional)
11.4 Medical Records Summary (optional)
[// GUIDANCE: Insert each addendum as a separately tabbed section labeled “Exhibit __[letter/number]”.]
12. INDEX OF EXHIBITS
Exhibit | Description | Pages | Language | Authenticity Note |
---|---|---|---|---|
A | Passport biographic page | 1 | English | Certified copy |
B | Police report dated [DATE] | 5 | Spanish | Certified translation attached |
… | … | … | … | … |
[// GUIDANCE: Provide a numbered (or lettered) index that ties directly to tabs/dividers in the physical or PDF submission.]
13. PROOF OF SERVICE
I, [NAME], declare under penalty of perjury that on [DATE] I served a true and correct copy of this Application, with all supporting materials, on the Department of Homeland Security by:
☐ Hand delivery to ICE/OPLA at [ADDRESS]
☐ U.S. Mail (first-class, postage prepaid) to [ADDRESS]
☐ Other: [DESCRIBE]
Executed on [DATE] at [CITY, STATE].
[SIGNATURE]
[// GUIDANCE: Double-check filing checklists for the specific venue. Some courts require separate barcode sheets, specialized service pages, or color cover sheets. Always paginate the entire packet consecutively and include bilingual certification for every translation under 8 C.F.R. § 103.2(b)(3).]