Form I 590 – Fill Out and Use This PDF

	Registration for Classification as Refugee	USCIS
	Department of Homeland Security	Form I-590
		OMB No. 1615-0068
	U.S. Citizenship and Immigration Services	Expires 12/31/2019
	For DHS Use Only

Part 1. Information About You

1. Family Name (Last Name)			Given Name (First Name)		Middle Name (if applicable)

2.Other Names Used (if any); include maiden name, names by previous marriages, and all aliases.

11.Identity documents, e.g., passport, national identification card and/or UNHCR identification card. Provide your complete name and date of birth as shown on each document listed.

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Part 2. Information About Your Parents

Provide the following information about your parents. Include living, deceased, biological, step and adoptive parents. (Use continuation page, if necessary.)

1. Parent 1
	Family Name (Last Name)				Given Name (First Name)				Middle Name (if applicable)
	Date of Birth (mm/dd/yyyy)		Relationship to You				Country of Birth

Street Number & Name, City, Province, Postal Code, and Country (Present Location. If deceased, write "deceased.")

2. Parent 2
	Family Name (Last Name)				Given Name (First Name)				Middle Name (if applicable)
	Date of Birth (mm/dd/yyyy)		Relationship to You				Country of Birth

Street Number & Name, City, Province, Postal Code, and Country (Present Location. If deceased, write "deceased.")

Part 3. Information About Your Background

1.Provide information about your residences during the past five years. List your present address first.

2.Provide information about the highest level of education that you completed, e.g., at university, college, trade or technical school, military academies, secondary or primary schools. (Use continuation page, if necessary.)

3.Provide information about your employment during the past five years. List your present or most recent employment first. (Use continuation page, if necessary.)

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Part 4. Military Service

Provide in chronological order information about ALL your military service and/or military-type training. (Use continuation page, if necessary.)

If none, check here and proceed to the section entitled "Relative In The United States."

1.Military Service

Part 5. Relative In The United States (I have the following close relative in the United States.)

1.Relative

Family Name (Last Name)		Given Name (First Name)		Middle Name (if applicable)

Relationship to You

Street Number & Name, City or Town, State, and Zip Code

Part 6. Information About Your Marital Status

Other Names Used by Spouse

Identity documents of spouse, e.g., passport, national identification card, UNHCR identification card. (If more than one identity document, use continuation page.)

Spouse's Name As	Date of Birth on	Document		Date of Issuance		Issuing
Shown on Document	Document	Type	Document Number	(mm/dd/yyyy)	Place of Issuance	Authority
	(mm/dd/yyyy)

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Part 6. Information About Your Marital Status (continued)

Current Spouse (continued)

Spouse's A-Number

RSC Case Number (if different from yours) Date of Birth (mm/dd/yyyy)

► A-

Place of Birth (Country, City/Town/Village)

Present Citizenship or Nationality

Ethnicity and/or Tribal Group

Gender

Date of Marriage (mm/dd/yyyy)

Place of Marriage (Country, City/Town/Village)

Is your spouse's address the same as yours?

Yes

No

If you answered "No," provide your current spouse's present location/address. If unknown, provide last known location and date. Street Number & Name, City or Town, Province, Postal Code, and Country

2.Former Spouse

Family Name (Last Name)		Given Name (First Name)		Middle Name (if applicable)

Other Names Used by Former Spouse

Other Names Used by Fiancé		Date of Engagement (mm/dd/yyyy)

Part 7. Information About Your Children

Check all of the boxes below that apply to you:	I have		(number) children (include living, deceased, or missing)
	I have no children (Go to Part 8)

I am currently pregnant

List ALL children, from the oldest child to the youngest child. Include all biological, legally adopted, and step-children, regardless of age or marital status. Also include children who are now missing or deceased. (Use continuation page, if necessary.)

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Part 7. Information About Your Children (continued)

Date of Birth (mm/dd/yyyy)		Place of Birth (Country, City/Town/Village)

Provide the following information ONLY if this child is NOT a case member.

Marital Status		If Married, Date of Marriage (mm/dd/yyyy) Present Citizenship or Nationality

Current Address (If unknown, provide last known location and date)

2.Child 2

Family Name (Last Name)				Given Name (First Name)		Middle Name (if applicable)
Date of Birth (mm/dd/yyyy)		Place of Birth (Country, City/Town/Village)

Provide the following information ONLY if this child is NOT a case member.

Marital Status		If Married, Date of Marriage (mm/dd/yyyy) Present Citizenship or Nationality

Current Address (If unknown, provide last known location and date)

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Part 7. Information About Your Children (continued)

Date of Birth (mm/dd/yyyy)		Place of Birth (Country, City/Town/Village)

Provide the following information ONLY if this child is NOT a case member.

Marital Status		If Married, Date of Marriage (mm/dd/yyyy) Present Citizenship or Nationality

Current Address (If unknown, provide last known location and date)

4.Child 4

Family Name (Last Name)				Given Name (First Name)		Middle Name (if applicable)
Date of Birth (mm/dd/yyyy)		Place of Birth (Country, City/Town/Village)

Provide the following information ONLY if this child is NOT a case member.

Marital Status	If Married, Date of Marriage (mm/dd/yyyy) Present Citizenship or Nationality

Current Address (If unknown, provide last known location and date)

Part 8. Information About Your Request For Refugee Status (Use continuation page, if necessary.)

1.What was the date and travel route when you first fled your country of citizenship/nationality, or if you are stateless, your country of last habitual residence?

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Part 8. Information About Your Request For Refugee Status (continued) (Use continuation page, if

necessary.)

2.Why did you first flee your country of citizenship/nationality, or if you are stateless, the country of your last habitual residence?

Part 9. Additional Information About Your Request For Refugee Status (Use continuation page, if

necessary.)

1.Have you EVER been fingerprinted by the U.S. government or the authorities of any other country?

2.Do you now hold, or have you EVER held, or have you EVER applied for, permanent residence, other permanent status, or citizenship/nationality, in any country other than your country of citizenship (or if you are stateless, the country of your last habitual residence)?

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Part 9. Additional Information About Your Request For Refugee Status (continued) (Use continuation

page, if necessary.)

4.List your present and past membership in - or affiliation with - ALL political, professional, or social organizations or groups, such as, but not limited to: student groups, labor unions, religious organizations, civil patrols, human rights groups, media organizations, funds, foundations, or societies. Include the name(s) of organization(s), location(s), dates of membership, as well as the purpose, character and nature of the organization(s). Include ranks held, promotions received, honors/recognitions given, regular duties, and dues paid.

If none, check here.

If “Yes,” provide details of all violations of law below, including: date, place, nature of charges, and final disposition, for each incident.

Part 10. Certification Of The Registrant, Interpreter, And Preparer

Registrant (Applicant) Certification

NOTE: Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2.

1.Registrant's Statement Regarding Interpreter

question, in

, a language in which I am fluent. I understand every question and instruction on

this form as translated to me by my interpreter, and have provided complete, true, and correct responses in the language indicated above.

Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that U.S. Citizenship and Immigration Services (USCIS) may require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any and all of my records that USCIS may need to determine my eligibility for the immigration benefit that I seek.

I furthermore authorize release of information contained in this form, in supporting documents, and in my USCIS records, to other entities and persons where necessary for the administration of U.S. immigration laws.

I certify, under penalty of perjury, that the information in my form and any document submitted with my form were provided by me and are complete, true, and correct.

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Part 10. Certification Of The Registrant, Interpreter, And Preparer (continued)

A.	Registrant's (Applicant's) Signature				Date of Signature (mm/dd/yyyy)
B.	Telephone Number (if any)		C. E-mail Address (if any)

Interpreter Certification

Provide the following information concerning the interpreter:

4.Interpreter's Name and Contact Information

A. Interpreter's Family Name (Last Name)			Interpreter's Given Name (First Name)
B.
	Interpreter's Business or Organization Name		Address	Telephone Number E-mail Address

5.Interpreter's Certification and Signature I certify that:

I am fluent in English and the same language provided in Part 10., Item B. in Item Number 1.; I have read to this registrant every question and instruction on this form, as well as the answer to every question, in the language provided in Part 10., Item B. in Item Number 1.; and the registrant has informed me that he or she understands every instruction and question on the form, as well as the answer to every question, and the registrant verified the accuracy of every answer.

Interpreter's Signature		Date of Signature (mm/dd/yyyy)
Additional Interpreter's Signature (if applicable)		Date of Signature (mm/dd/yyyy)

Preparer Certification

Provide the following information concerning the preparer:

6.Preparer's Name and Contact Information

A.	Preparer's Family Name (Last Name)				Preparer's Given Name (First Name)
B.	Preparer's Business or Organization		Address			Telephone Number Fax Number			E-mail Address
	Name

7.Preparer's Statement, Certification, and Signature

By my signature, I certify, swear or affirm, under penalty of perjury, that I prepared this form on behalf of, at the request of, and with the express consent of the registrant (applicant). I completed the form based only on responses the registrant (applicant) provided to me. After completing the form, I reviewed it and all of the registrant's (applicant's) responses with the registrant (applicant), who agreed with every answer on the form. If the registrant (applicant) supplied additional information concerning a question on the form, I recorded it on the form.

	Preparer's Signature		Date of Signature (mm/dd/yyyy)
	Additional Preparer's Signature (if applicable)		Date of Signature (mm/dd/yyyy)
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Part 11. Admissibility

Provide details of all violations of law on continuation page, if not previously recorded in Part 9 of this form, including: date, place, nature of charges, and final disposition, for each incident.

Date (mm/dd/yyyy)	Location	Type of Immigration Benefit	Status (status	Were you the
			granted or denied)	principal applicant?
				Yes	No

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Part 11. Admissibility (continued)

10.Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following:

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Part 11. Admissibility (continued)

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Do not write below this line. For Government use only.

THIS SECTION IS TO BE COMPLETED ONLY IN THE PRESENCE OF THE U.S. GOVERNMENT OFFICIAL

RESPONSIBLE FOR ADJUDICATING THIS REGISTRATION.

I, the undersigned, do swear or affirm that I know the contents of this registration subscribed by me, including any attached documents, and that they are true to the best of my knowledge, and that corrections numbered ____ to ____ were made by me or at

my request. Each and every question and instruction on this form was read to me in ____________________, a language in which I

am fluent. I understand each and every question and instruction on this form, as well as my answer to each question. I agree to report any changes in family composition, such as births, deaths, marriages, divorces and engagements, to the U.S. Government via the Resettlement Support Center.

(True and Complete Signature of Registrant)

OPTIONAL: I authorize USCIS to release information contained in or pertaining to my application for refugee status to the U.N. High Commissioner for Refugees, other U.S. Government agencies, and other resettlement countries. I understand that no information regarding my refugee claim will be shared with the government of the country from which I am seeking refuge. I understand that I am not required to sign this waiver, and I do so voluntarily.

(True and Complete Signature of Registrant)

Subscribed and sworn to before me by the above named registrant at __________________ on __________________________

(Location)(Date, mm/dd/yyyy)

RE-INTERVIEW (if applicable): I, the undersigned, hereby reaffirm the contents of this registration and my answers to every question on this form, as well as the answers I have provided in my interview on this date.

(True and Complete Signature of Registrant)

Subscribed and sworn to before me by the above named registrant at __________________ on __________________________

(Location)

(Date, mm/dd/yyyy)

Interpreter's Certification and Signature

I certify that: I am fluent in English the same language provided in Part 10., Item B. in Item Number 1.; I have read to this registrant every question and instruction on this form, as well as the answer to every question, in the language provided in Part 10., Item B. in Item Number 1.; and the registrant has informed me that he or she understands every instruction and question on the form, as well as the answer to every question, and the registrant verified the accuracy of every answer.

1.	Name of Interpreter	2. Signature of Interpreter

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Part 12. Additional Information About Your Registration for Classification as Refugee Continuation Sheet

If you need extra space to provide any additional information within this form, use the space below. If you need more space than what is provided, you may make copies to complete and file with this form or attach a separate sheet of paper. Include your name, your Alien Registration Number (A-Number) (if any) and RSC Case Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet.

1.a. Page Number		1.b. Part Number		1.c. Item Number
1.d.

2.a. Page Number		2.b. Part Number		2.c. Item Number

2.d.

3.a. Page Number		3.b. Part Number		3.c. Item Number

3.d.

4.a. Page Number		4.b. Part Number		4.c. Item Number

4.d.

	Registrant's (Applicant's) Signature	Date of Signature (mm/dd/yyyy)

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Instructions

How To Fill Out Form I-590

1.Type or print legibly in black ink.

2.If you need extra space to complete any item within this form, use the space provided in Part 12. Additional Information About Your Registration for Classification as Refugee Continuation Sheet. Type or print the registrant's name and Alien Registration Number (A-Number) (if any) and Resettlement Support Center ("RSC") Case Number (if any) at the top of each continuation sheet; indicate the Page Number, Part Number, and Item Number to which the answer refers.

3.Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been married and the question asks, "Provide the name of your current spouse"), type or print "N/A," unless otherwise directed. If your answer to a question which requires a numeric response is zero or none (for example, "How many children do you have" or “How many times have you departed the United States"), type or print "None," unless otherwise directed.

4.If you do not completely fill out this form or fail to submit required documents listed in the Instructions and your biometrics, if required, processing of your request will be delayed, and USCIS may reject, close, or deny your form.

5.Signature. Each form must be properly signed. For all signatures on this form, USCIS will not accept a stamped or typewritten name in place of a signature. If you are under 14 years of age, your parent or legal guardian may sign the form on your behalf. A legal guardian may also sign for a mentally incompetent person.

6.Biometrics. You may be required, to provide fingerprints, photograph, and/or additional signature to verify your identity, obtain additional information, and conduct background and security checks, including a check of criminal history records. You will be informed when and where you will need to provide these biometrics. If you fail to provide these biometrics as requested, USCIS may reject, close, or deny your form.

7.Requests for More Information. We may request that you provide more information or evidence to support your form. You may submit legible photocopies of documents requested, unless the Instructions specifically state that you must submit an original document. USCIS may request an original document at the time of filing or at any time during processing of your form. If you submit original documents when not required, the documents may be destroyed or remain a part of the record, and USCIS will not automatically return them to you.

8.Translations. If you submit a document with information in a foreign language, you must also submit a full English translation. The translator must sign a certification that the English language translation is complete and accurate, and that he or she is competent to translate from the foreign language into English. The certification must include the translator's signature. USCIS recommends the certification contain the translator's printed name and the date and the translator's contact information. Translations prepared and signed by an RSC employee working for the U.S. Department of State or under contract will be considered as complete and accurate.

Submission of Form - The RSC with jurisdiction in the registrant's region shall assist the registrant in the completion and submission of Form I-590, Registration for Classification as Refugee.

Registration - A separate Form I-590 is required for each registrant. Form I-590 on behalf of a child under 14 years of age may be submitted by the parent or guardian.

USCIS Privacy Act Statement

AUTHORITIES: The information requested on this form, and the associated evidence, is collected pursuant to 8 U.S.C. 1522(b) and 8 U.S.C. section 1157.

PURPOSE: The primary purpose for providing the requested information on this form is to determine eligibility for refugee classification and resettlement in the United States.

DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and any requested evidence, may delay a final decision or result in the denial of your benefit request.

ROUTINE USES: The information you provide on this form may be shared with other Federal, state, local, and foreign government agencies and authorized organizations in accordance with approved routine uses, as described in the associated published system of records notices [DHS/USCIS-001 - Alien File, Index, and National File Tracking System, DHS/USCIS-017 - Refugee Case Processing and Security Screening Information, and the STATE-60 - Refugee Case Records, which can be found at www.dhs.gov/privacy and www.state.gov]. The information may also be made available, as appropriate for law enforcement purposes or in the interest of national security.

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Paperwork Reduction Act

An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The public reporting burden for Form I-590 is estimated at 3 hours for gathering information; 20 minutes (.33 hours) for submitting biometric information; 1 hour for review the request; and 2 hours for collecting DNA evidence (if applicable). Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-2140; OMB No 1615-0068. Do not mail

your completed Form I-590 to this address.

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