Immigration I-589 Packet

IMMIGRATION I-589 PACKET

Applicant Information

A-Number:    Date of Birth:

Telephone:    Email:

Entry and Immigration History

Date of most recent arrival to the United States:

I-94 Number (if any):    Current immigration status:

Dependents and Household

Spouse full name:    Date of birth:

Basis for Asylum Claim — Statement of Fear/Persecution

Describe the factual basis for your asylum claim, including dates, locations, perpetrators, and why you fear return. Provide specific incidents and link each incident to one or more protected grounds (race, religion, nationality, political opinion, membership in a particular social group).

Arrival, Proceedings, and Prior Applications

Have you previously filed an asylum application in the United States?   Yes   No

Criminal and Adverse History

Have you ever been arrested, charged, convicted, or detained by any authority?   Yes   No

Evidence Checklist

Include with this packet (check all that apply):
Passport or travel document    National identity documents
Police reports or medical records    Affidavits from witnesses
Country condition materials    Other (specify)

Interpreter/Preparer Attestation

Did anyone assist you in completing this packet?   Yes   No

Declaration and Certification

I certify, under penalty of perjury under the laws of the United States, that the statements made in this packet are true and correct to the best of my knowledge and that I understand the penalties for knowingly filing false statements. I authorize the representative identified in the Representation Agreement below to prepare and file Form I‑589 and related documents on my behalf.

Representation Agreement (Attorney-Client Retainer)

WHEREAS, Client Name:    seeks legal representation to prepare, file, and prosecute an asylum application (Form I-589) and related immigration matters; and

WHEREAS, Representative Name: agrees to represent Client in accordance with the terms below; and

WHEREAS, the parties wish to set forth their entire agreement regarding the scope, payment, and termination of representation.

Scope of Work

Representative will provide legal services necessary to prepare and file Form I-589, represent Client in interviews or hearings related to the asylum claim, advise Client regarding evidence collection, and communicate with relevant immigration authorities and opposing parties as authorized below.

Payment Terms

Client agrees to pay Representative for services rendered under this Agreement as follows:

Client authorizes Representative to withdraw funds from retainer for billed services and to require replenishment of the retainer when depleted.

Term and Termination

This Agreement begins on Start Date: and will continue until End Date: unless earlier terminated.

Either party may terminate this Agreement upon written notice. Notice period (days):

Upon termination, Client remains responsible for payment of all fees and costs incurred through the effective date of termination and for reasonable wind-up costs incurred by Representative.

Confidentiality

Representative shall maintain as confidential all information provided by Client in the course of representation, subject to legal and ethical obligations, including the duty to disclose where required by law or court order. Client consents to disclosure to necessary third parties for the preparation of evidence, including translators, expert witnesses, and the immigration authorities, provided such disclosures are limited to relevant information.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the state governing the Representative's practice, without regard to conflict of law principles.

Entire Agreement

This Agreement contains the entire understanding of the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, oral or written, between the parties. Any amendment must be in writing and signed by both parties.

By signing below, Client certifies that they have read and understand this packet and Representation Agreement, that the information provided herein is true to the best of their knowledge, and that they authorize Representative to file Form I-589 and take such actions as authorized above.

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