Legal Asylum Withdrawal Form

LEGAL ASYLUM WITHDRAWAL FORM

This Asylum Withdrawal Instrument is executed on this date by Applicant Name: , Date of Birth: , Alien Registration Number (A-Number): , Case Number: , filed with Authority/Office: .

Representative Name: , Firm or Organization: , Bar/ID Number: .

RECITALS

WHEREAS, the Applicant submitted an application for asylum, withholding of removal, and related relief under applicable immigration law and regulations in connection with the above-referenced case; and

WHEREAS, the Applicant now elects to withdraw the asylum application in whole or in part and seeks to record that withdrawal in a manner sufficient for administrative processing and for the record; and

WHEREAS, the Representative has provided counsel and information to the Applicant regarding the legal consequences of withdrawal and the Applicant desires the Representative to assist in effecting the withdrawal;

NOW THEREFORE

In consideration of the mutual promises and covenants contained herein and for other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the parties agree as follows.

1. DEFINITIONS

For purposes of this instrument, "Application" means the asylum application and any ancillary applications or requests for relief associated with the above-referenced case number; "Withdrawal" means the formal, written act described in Section 2 below.

2. WITHDRAWAL OF APPLICATION

The Applicant hereby withdraws the Application as follows (select one):

Full withdrawal of all claims, petitions, and applications in the above-referenced file.

Partial withdrawal limited to the following specific claim(s) or document(s):

3. EFFECTS AND CONSEQUENCES

The Applicant acknowledges and agrees that the Withdrawal will, upon receipt and processing by the receiving authority, terminate administrative consideration of the withdrawn claim(s). The Applicant understands that withdrawal may preclude the right to refile the same claim without new evidence or changed circumstances, may affect eligibility for relief tied to the Application, and may be considered in subsequent immigration or removal proceedings.

The Representative will submit the Withdrawal to the appropriate office on behalf of the Applicant and will take commercially reasonable steps to confirm receipt. The Representative makes no guarantee regarding the timing of administrative processing or the effect of the Withdrawal on any concurrent or subsequent proceedings.

4. REPRESENTATIONS AND WARRANTIES

The Applicant represents and warrants that: (a) the Applicant is the person identified above and is competent to execute this instrument; (b) the decision to withdraw the Application is made knowingly, voluntarily, and without coercion; and (c) no other person or entity has authority to withdraw the Application on the Applicant's behalf except the Representative identified herein.

The Representative represents and warrants that, to the extent the Representative has provided legal advice, such advice has been provided in accordance with applicable professional obligations and that the Representative will memorialize the Withdrawal in writing and deliver it to the appropriate office or official designated by the Applicant.

5. NOTICES

All notices required or permitted under this instrument must be in writing and delivered to the other party at the following addresses. Notice is effective upon delivery or, if mailed, three business days after deposit with the postal service.

6. VOLUNTARY CERTIFICATION

Certification: By signing below the Applicant certifies under penalty of perjury under the laws of the applicable jurisdiction that the statements set forth in this instrument are true and correct to the best of the Applicant's knowledge and that the Applicant executes this Withdrawal voluntarily and with full understanding of its consequences.

The Applicant acknowledges receipt of counsel or the opportunity to obtain counsel prior to executing this document and acknowledges that the Representative has explained the known risks and consequences of withdrawal.

Interpreter present at signing: Language:

7. AMENDMENT; WAIVER; COUNTERPARTS

This instrument may be amended only by a written instrument signed by the parties. No waiver of any provision is effective unless in writing and signed by the waiving party. This instrument may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one instrument.

8. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

Governing Law: This instrument shall be governed by and construed in accordance with the laws and applicable procedures of the jurisdiction with authority over the underlying immigration matter, without regard to conflict of laws principles.

Entire Agreement: This instrument contains the entire agreement of the parties concerning the Withdrawal and supersedes all prior oral or written agreements concerning the subject matter hereof.

Severability: If any provision of this instrument is held invalid or unenforceable, the remainder of this instrument will remain in full force and effect.

9. ADDITIONAL ACKNOWLEDGMENTS

The Applicant acknowledges and initials the following (check each box to indicate acknowledgment):

I understand the possible immigration consequences of withdrawing my asylum application.

My decision to withdraw is voluntary and not the result of coercion, threats, or promises.

I have been informed of alternatives to withdrawal, including continuation of proceedings or other relief.

10. ADMINISTRATIVE INSTRUCTIONS

Submission Method Requested:

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