Home Part 1 Part 2 Part 3 Part 4 Part 5 Part 6 Part 7 Part 11

Supplement A, Form 1-589

A-Number (If available)

Date

Applicant's Name

Applicant's Signature __________________________________________

List All of Your Children, Regardless of Age or Marital Status

(NOTE: Use this form and attach additional pages and documentation as needed, if you have more than four children)

1. Alien Registration Number (A-Number)(if any)

2. Passport/ID Card Number (if any)

3. Marital Status (Married, Single, Divorced, Widowed)

4. U.S. Social Security Number (if any)

5. Complete Last Name

6. First Name

7. Middle Name

8. Date of Birth (mm/dd/yyyy)

9. City and Country of Birth

10. Nationality (Citizenship)

11. Race, Ethnic, or Tribal Group

12. Gender

Male

Female

13. Is this child in the U.S. ?

Yes (Complete Blocks 14 to 21.)

No (Specify location).

Location.

14. Place of last entry into the U.S.

15. Date of last entry into the U.S.(mm/dd/yyyy)

16. 1-94 Number (If any)

17. Status when last admitted (Visa type, if amy)

18. What is your child's current status?

19. What 1s the expiration date of his/her authorized stay, if any? (mm/dd/yyyy)

20. Is your child in Immigration Court proceedings?

Yes

No

21. If in the U.S, is this child to be included in this application? (Check the appropriate box.)

Yes

(Attach one photograph of your child in the upper right corner of Page 9 on the extra

copy of the application submitted for this person.)

No

Child Number 2:

1. Alien Registration Number (A-Number)(if any)

2. Passport/ID Card Number (if any)

3. Marital Status (Married, Single, Divorced, Widowed)

4. U.S. Social Security Number (if any)

5. Complete Last Name

6. First Name

7. Middle Name

8. Date of Birth (mm/dd/yyyy)

9. City and Country of Birth

10. Nationality (Citizenship)

11. Race, Ethnic, or Tribal Group

12. Gender

Male

Female

13. Is this child in the U.S. ?

Yes (Complete Blocks 14 to 21.)

No (Specify location).

Location.

14. Place of last entry into the U.S.

15. Date of last entry into the U.S.(mm/dd/yyyy)

16. 1-94 Number (If any)

17. Status when last admitted (Visa type, if amy)

18. What is your child's current status?

19. What 1s the expiration date of his/her authorized stay, if any? (mm/dd/yyyy)

20. Is your child in Immigration Court proceedings?

Yes

No

21. If in the U.S, is this child to be included in this application? (Check the appropriate box.)

Yes

(Attach one photograph of your child in the upper right corner of Page 9 on the extra

copy of the application submitted for this person.)

No

Assistant