Fill and Sign the Asylum Application Form

Affidavit of Applicant in Support of Asylum Application State of __________________________ County of ________________________ ___________________________ (Name of Affiant) , being first duly sworn, deposes and says: 1. I reside at ____________________________________________________ (address of affiant) , _______________________ (name of city) , _______________________ (name of county) , _________________________ (name of state) . 2. I was born on ____________________ (date of birth) , in _____________________ (name of city) , ________________________ (name of country) . 3. Until _____________________ (date of end of employment) , I was a _____________ ____________________ (description of job title) at ___________________________ (place of employment) in _____________________ (name of city) . My duties included (description of duties) __________________________________________________ ______________________________________________________________________ . 4. I have been informed by a former coworker that my work unit, described above, has reported me for spreading information abroad concerning the (description of political incident in affiant's home country) ________________________________________ ____________________________________________________________________ in _________________ (identification of month) , ___________ (identification of year) . 5. I have been an outspoken critic of the ____________________________ (name of ruling party in affiant's home country) both before and after the (description of political incident in affiant's home country) _________________________________ ______________________________________________________________________ . After the (description of political incident in affiant's home country ) _____________ _____________________________________________________________________. I relayed information to overseas groups opposed to the _________________________ (name of ruling party in affiant's home country) about the (description of political incident in affiant's home country) ________________________________________ ______________________________________________________________________ . This activity was reported to the government by my work unit. I have also discussed my opposition to the activities and programs of _____________________________ (name of ruling party in affiant's home country) , particularly in regard to the (description of political incident in affiant's home country) _________________________________ ______________________________________________________________________ , with many persons, including both my coworkers and foreign friends. 6. I fear that I will be severely persecuted in _____________________ (name of country) . I am convinced that I already have a bad record with the _________________________ (name of security bureau) . I truly believe that at a minimum I would receive a ______ (number of years) -year sentence at a labor camp or possibly just “disappear” if I were to return to ________________________ (name of country) . This punishment would be for simply expressing my political opinion. ________________________________ (Signature of Affiant) ________________________________ (Print or Type Name) SWORN to and subscribed before me, this the ______ day of _______________, 20______. __________________________ NOTARY PUBLIC My Commission Expires: ______________________