Part AIII. Information About Your Background

1. List your last address where you lived before coming to the United States.

If this is not the country where you fear persecution, also list the last

address in the country where you fear persecution.

(List Address, City/Town, Department, Province, or State and Country.)

(NOTE: Use Form 1-589 Supplement B, or additional sheets of paper, if necessary.)

Address before coming to America 1

Number and Street (Provide if available)
City/Town
Department, Province, or State
Country
Date From (Mo/Yr)
Date To (Mo/Yr)

Address before coming to America 2

Number and Street (Provide if available)
City/Town
Department, Province, or State
Country
Date From (Mo/Yr)
Date To (Mo/Yr)

2. Provide the following information about your residences during the past 5 years.

List your present address first.

(NOTE: Use Form I-589 Supplement B, or additional sheets of paper, if necessary.)

Address in America 1

Number and Street
City/Town
Department, Province, or State
Country
Date From (Mo/Yr)
Date To (Mo/Ty)

Address in America 2

Number and Street
City/Town
Department, Province, or State
Country
Date From (Mo/Yr)
Date To (Mo/Ty)

Address in America 3

Number and Street
City/Town
Department, Province, or State
Country
Date From (Mo/Yr)
Date To (Mo/Ty)

Address in America 4

Number and Street
City/Town
Department, Province, or State
Country
Date From (Mo/Yr)
Date To (Mo/Ty)

Address in America 5

Number and Street
City/Town
Department, Province, or State
Country
Date From (Mo/Yr)
Date To (Mo/Ty)

3. Provide the following information about your education, beginning with the

most recent school that you attended.

(NOTE: Use Form 1-589 Supplement B, or additional sheets of paper, if necessary.)

School attended 1

Name of School
Type of School
Location (Address)
Attended From (Mo/Yr)
Attended To (Mo/Yr)

School attended 2

Name of School
Type of School
Location (Address)
Attended From (Mo/Yr)
Attended To (Mo/Yr)

School attended 3

Name of School
Type of School
Location (Address)
Attended From (Mo/Yr)
Attended To (Mo/Yr)

School attended 4

Name of School
Type of School
Location (Address)
Attended From (Mo/Yr)
Attended To (Mo/Yr)

4. Provide the following information about your employment during the past 5 years.

List your present employment first.

(NOTE: Use Form 1-589 Supplement B, or additional sheets of paper, if necessary.)

Employer address 1

Name and Address of Employer
Your Occupation
Date From (Mo/Yr)
Date To (Mo/Yr)

Employer address 2

Name and Address of Employer
Your Occupation
Date From (Mo/Yr)
Date To (Mo/Yr)

Employer address 3

Name and Address of Employer
Your Occupation
Date From (Mo/Yr)
Date To (Mo/Yr)

5. Provide the following information about your parents and siblings (brothers and sisters).

Check the box if the person is deceased.

(NOTE: Use Form 1-589 Supplement B, or additional sheets of paper, if necessary.)

Parents and Siblings : Mother

Full Name
City/Town and Country of Birth
Current Location
Deceased

Parents and Siblings : Father

Full Name
City/Town and Country of Birth
Current Location
Deceased

Parents and Siblings : Sibling 1

Full Name
City/Town and Country of Birth
Current Location
Deceased

Parents and Siblings : Sibling 2

Full Name
City/Town and Country of Birth
Current Location
Deceased

Parents and Siblings : Sibling 3

Full Name
City/Town and Country of Birth
Current Location
Deceased

Parents and Siblings : Sibling 4

Full Name
City/Town and Country of Birth
Current Location
Deceased

Assistant