Form I-590 Registration for Classification as a Refugee

Registration for Classification as Refugee

USCIS
Form I-590

Department of Homeland Security
U.S. Citizenship and Immigration Services

OMB No. 1615-0068
Expires 08/31/2025

DRAFT
NOT FOR
PRODUCTION
10/17/2023
For DHS Use Only

Port of Entry

Alien Registration Number (A-Number)

A-

Action Block

Photograph

Action Block

Resettlement Support Center
(RSC) Case Number

U.S. Social Security Number (if any)

RE-

Part 1. Information About You

Given Name (First Name)

1.

Family Name (Last Name)

2.

Other Names Used (if any); include maiden name, names by previous marriages, and all aliases.

3.

Date of Birth (mm/dd/yyyy)

4.

Gender

5.

Place of Birth (Country, City/Town/Village)

6.

Present Citizenship or Nationality

7.

Ethnicity and/or Tribal Group

8.

Religion (if any)

9.

Language (native)

10.

Other Languages that You Speak

11.

Identity documents, e.g., passport, national identification card and/or UNHCR identification card. Provide your complete name
and date of birth as shown on each document listed.

Middle Name (if applicable)

Your Name As Shown Date of Birth on Document Document Number Date of Issuance Place of Issuance
on Document
Document
Type
(mm/dd/yyyy)
(mm/dd/yyyy)

Form I-590 Edition 08/10/22

Issuing
Authority

Page 1 of 16

Family Name:

RSC Case #:

A-

Part 2. Information About Your Parents
Provide the following information about your parents. Include living, deceased, biological, step and adoptive parents.
(Use continuation page, if necessary.)
1.

Parent 1

DRAFT
NOT FOR
PRODUCTION
10/17/2023
Given Name (First Name)

Family Name (Last Name)

Relationship to You

Date of Birth (mm/dd/yyyy)

Middle Name (if applicable)

Country of Birth

Street Number & Name, City, Province, Postal Code, and Country (Present Location. If deceased, write "deceased.")

2.

Parent 2

Family Name (Last Name)

Given Name (First Name)

Relationship to You

Date of Birth (mm/dd/yyyy)

Middle Name (if applicable)

Country of Birth

Street Number & Name, City, Province, Postal Code, and Country (Present Location. If deceased, write "deceased.")

Part 3. Information About Your Background
1.

Provide information about your residences during the past five years. List your present address first.
Street Number and Name

2.

Province or State

Country

From
Month/Year

To
Month/Year

Provide information about the highest level of education that you completed, e.g., at university, college, trade or technical
school, military academies, secondary or primary schools. (Use continuation page, if necessary.)
Name of School

3.

City

Location of School

Type of School or
Course of Study

Title of Degree

From
Month/Year

To
Month/Year

Provide information about your employment during the past five years. List your present or most recent employment first.
(Use continuation page, if necessary.)
Name of Employer

Form I-590 Edition 08/10/22

Address of Employer

Occupation

From
Month/Year

To
Month/Year

Page 2 of 16

Family Name:

A-

RSC Case #:

Part 4. Military Service
Provide in chronological order information about ALL your military service and/or military-type training.
(Use continuation page, if necessary.)

DRAFT
NOT FOR
PRODUCTION
10/17/2023

If none, check here and proceed to the section entitled "Relative In The United States."
1.

Military Service
Military Service or
Organization that
Trained You

Country

Specialty (ex.
Duty Location Artillery, Infantry, Highest Rank
Intelligence, etc.)

Unit

Dates of Service
(mm/dd/yyyy)
From
To

Part 5. Relative In The United States (I have the following close relative in the United States.)
1.

Relative

Family Name (Last Name)

Given Name (First Name)

Middle Name (if applicable)

Relationship to You

Street Number & Name, City or Town, State, and Zip Code

Part 6. Information About Your Marital Status
Your Current Marital Status (check ALL that apply):
Married (Go to section entitled
"Current Spouse")
Unmarried but engaged to be married
(Go to section entitled "Fiancé")
1.

Never married and not engaged
(Go to Part 7)
Widowed (Go to section entitled
“Former Spouse”)

Divorced (Go to section entitled
"Former Spouse")
Missing Spouse (Go to section
entitled "Current Spouse")

Current Spouse
Family Name (Last Name)

Given Name (First Name)

Middle Name (if applicable)

Other Names Used by Spouse

My spouse

will

will not accompany me to the United States.

Identity documents of spouse, e.g., passport, national identification card, UNHCR identification card. (If more than one identity
document, use continuation page.)
Spouse's Name As
Shown on Document

Form I-590 Edition 08/10/22

Date of Birth on
Document
Date of Issuance
Document
Document Number
Place of Issuance
Type
(mm/dd/yyyy)
(mm/dd/yyyy)

Issuing
Authority

Page 3 of 16

Family Name:

A-

RSC Case #:

Part 6. Information About Your Marital Status (continued)
Current Spouse (continued)

DRAFT
NOT FOR
PRODUCTION
10/17/2023

Spouse's A-Number
► A-

RSC Case Number (if different from yours) Date of Birth (mm/dd/yyyy)

Place of Birth (Country, City/Town/Village)

Present Citizenship or Nationality

Ethnicity and/or Tribal Group

Gender

Date of Marriage (mm/dd/yyyy)

Place of Marriage (Country, City/Town/Village)

Is your spouse's address the same as yours?

Yes

No

If you answered "No," provide your current spouse's present location/address. If unknown, provide last known location and date.
Street Number & Name, City or Town, Province, Postal Code, and Country

2.

Former Spouse

Family Name (Last Name)

Given Name (First Name)

Middle Name (if applicable)

Date of Marriage (mm/dd/yyyy)

Date Marriage Terminated (mm/dd/yyyy)

Other Names Used by Former Spouse
Date of Birth (mm/dd/yyyy)

Check all that apply:

3.

Divorced

Deceased

Missing

Date last seen
(mm/dd/yyyy)

Fiancé
Family Name (Last Name)

Given Name (First Name)

Other Names Used by Fiancé

Middle Name (if applicable)
Date of Engagement (mm/dd/yyyy)

Part 7. Information About Your Children
Check all of the boxes below that apply to you:

I have

(number) children (include living, deceased, or missing)

I have no children (Go to Part 8)
I am currently pregnant
List ALL children, from the oldest child to the youngest child. Include all biological, legally adopted, and step-children, regardless of
age or marital status. Also include children who are now missing or deceased. (Use continuation page, if necessary.)

Form I-590 Edition 08/10/22

Page 4 of 16

Family Name:

A-

RSC Case #:

Part 7. Information About Your Children (continued)
1.

Child 1

DRAFT
NOT FOR
PRODUCTION
10/17/2023

This child is my (check one):

Son

This child is my (check one):

Biological Child

This child is (check one):

Living

Daughter

Legally Adopted Child

Deceased

Will this child accompany you to the United States?

Step-Child

Missing

Yes

No

Child's Complete Name

Family Name (Last Name)

Date of Birth (mm/dd/yyyy)

Given Name (First Name)

Middle Name (if applicable)

Place of Birth (Country, City/Town/Village)

Provide the following information ONLY if this child is NOT a case member.
Marital Status

If Married, Date of Marriage (mm/dd/yyyy) Present Citizenship or Nationality

Current Address (If unknown, provide last known location and date)

2.

Child 2

This child is my (check one):

Son

Daughter

This child is my (check one):

Biological Child

This child is (check one):

Living

Legally Adopted Child

Deceased

Will this child accompany you to the United States?

Step-Child

Missing

Yes

No

Child's Complete Name
Family Name (Last Name)
Date of Birth (mm/dd/yyyy)

Given Name (First Name)

Middle Name (if applicable)

Place of Birth (Country, City/Town/Village)

Provide the following information ONLY if this child is NOT a case member.
Marital Status

If Married, Date of Marriage (mm/dd/yyyy) Present Citizenship or Nationality

Current Address (If unknown, provide last known location and date)

Form I-590 Edition 08/10/22

Page 5 of 16

Family Name:

A-

RSC Case #:

Part 7. Information About Your Children (continued)
3.

Child 3

DRAFT
NOT FOR
PRODUCTION
10/17/2023

This child is my (check one):

Son

Daughter

This child is my (check one):

Biological Child

This child is (check one):

Living

Legally Adopted Child

Deceased

Will this child accompany you to the United States?

Step-Child

Missing

Yes

No

Child's Complete Name

Family Name (Last Name)

Date of Birth (mm/dd/yyyy)

Given Name (First Name)

Middle Name (if applicable)

Place of Birth (Country, City/Town/Village)

Provide the following information ONLY if this child is NOT a case member.
Marital Status

If Married, Date of Marriage (mm/dd/yyyy) Present Citizenship or Nationality

Current Address (If unknown, provide last known location and date)

4.

Child 4

This child is my (check one):

Son

Daughter

This child is my (check one):

Biological Child

This child is (check one):

Living

Legally Adopted Child

Deceased

Will this child accompany you to the United States?

Step-Child

Missing

Yes

No

Child's Complete Name
Family Name (Last Name)
Date of Birth (mm/dd/yyyy)

Given Name (First Name)

Middle Name (if applicable)

Place of Birth (Country, City/Town/Village)

Provide the following information ONLY if this child is NOT a case member.
Marital Status

If Married, Date of Marriage (mm/dd/yyyy) Present Citizenship or Nationality

Current Address (If unknown, provide last known location and date)

Part 8. Information About Your Request For Refugee Status (Use continuation page, if necessary.)
1.

What was the date and travel route when you first fled your country of citizenship/nationality, or if you are stateless, your
country of last habitual residence?

Form I-590 Edition 08/10/22

Page 6 of 16

Family Name:

A-

RSC Case #:

Part 8. Information About Your Request For Refugee Status (continued) (Use continuation page, if
necessary.)

DRAFT
NOT FOR
PRODUCTION
10/17/2023

2.

Why did you first flee your country of citizenship/nationality, or if you are stateless, the country of your last habitual residence?

3.

Have you EVER returned to your country?

Yes

No

If "Yes," when and why did you return?

Part 9. Additional Information About Your Request For Refugee Status (Use continuation page, if
necessary.)
1.

Have you EVER been fingerprinted by the U.S. government or the authorities of any other country?
Yes (explain below)

2.

Do you now hold, or have you EVER held, or have you EVER applied for, permanent residence, other permanent status, or
citizenship/nationality, in any country other than your country of citizenship (or if you are stateless, the country of your last
habitual residence)?
Yes (explain below)

3.

No

No

Have you EVER been to the United States?

Yes

No

If "Yes," provide the information requested in the table below for each trip to the United States.
Date of Entry
(mm/dd/yyyy)

Form I-590 Edition 08/10/22

Place of Entry

Status

Visa Number

A-Number

Date of Exit
(mm/dd/yyyy)

Place of Exit

Page 7 of 16

Family Name:

A-

RSC Case #:

Part 9. Additional Information About Your Request For Refugee Status (continued) (Use continuation
page, if necessary.)
4.

List your present and past membership in - or affiliation with - ALL political, professional, or social organizations or groups,
such as, but not limited to: student groups, labor unions, religious organizations, civil patrols, human rights groups, media
organizations, funds, foundations, or societies. Include the name(s) of organization(s), location(s), dates of membership, as well
as the purpose, character and nature of the organization(s). Include ranks held, promotions received, honors/recognitions given,
regular duties, and dues paid.

DRAFT
NOT FOR
PRODUCTION
10/17/2023

If none, check here.

5.

Have you EVER been charged with a violation of law?

Yes

No

If “Yes,” provide details of all violations of law below, including: date, place, nature of charges, and final disposition, for each
incident.

Part 10. Certification Of The Registrant, Interpreter, And Preparer
Registrant (Applicant) Certification

NOTE: Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2.
1.

2.

Registrant's Statement Regarding Interpreter
A.

I can read and understand English, and have read and understand every question and instruction on this form, as well as
my answer to every question.

B.

The interpreter named below has read to me every question and instruction on this form, as well as my answer to every
question, in
, a language in which I am fluent. I understand every question and instruction on
this form as translated to me by my interpreter, and have provided complete, true, and correct responses in the language
indicated above.

Registrant's Statement Regarding Preparer
I have requested the services of and consented to
is not an attorney or accredited representative, preparing this form for me.
who
is

3.

,

Registrant's Statement Regarding Disclosure of Information to Social Security Administration
By checking this box, and upon USCIS determining I meet the definition of a refugee with work authorization, I authorize
disclosure of my information to the Social Security Administration for the purpose of assigning me a Social Security
number and issuing me a Social Security card.

4.

Registrant (Applicant) Certification
Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that U.S.
Citizenship and Immigration Services (USCIS) may require that I submit original documents to USCIS at a later date.
Furthermore, I authorize the release of any information from any and all of my records that USCIS may need to determine my
eligibility for the immigration benefit that I seek.
I furthermore authorize release of information contained in this form, in supporting documents, and in my USCIS records, to
other entities and persons where necessary for the administration of U.S. immigration laws.
I certify, under penalty of perjury, that the information in my form and any document submitted with my form were provided by
me and are complete, true, and correct.

Form I-590 Edition 08/10/22

Page 8 of 16

Family Name:

A-

RSC Case #:

Part 10. Certification Of The Registrant, Interpreter, And Preparer (continued)
A.

Registrant's (Applicant's) Signature

B.

Telephone Number (if any)

Date of Signature (mm/dd/yyyy)

DRAFT
NOT FOR
PRODUCTION
10/17/2023
C.

E-mail Address (if any)

Interpreter Certification

Provide the following information concerning the interpreter:
5.

6.

Interpreter's Name and Contact Information
A.

Interpreter's Family Name (Last Name)

B.

Interpreter's Business or Organization Name

Interpreter's Given Name (First Name)

Address

Telephone Number E-mail Address

Interpreter's Certification and Signature
I certify that:

I am fluent in English and the same language provided in Part 10., Item B. in Item Number 1.; I have read to this registrant
every question and instruction on this form, as well as the answer to every question, in the language provided in Part 10., Item
B. in Item Number 1.; and the registrant has informed me that he or she understands every instruction and question on the
form, as well as the answer to every question, and the registrant verified the accuracy of every answer.
Interpreter's Signature

Date of Signature (mm/dd/yyyy)

Additional Interpreter's Signature (if applicable)

Date of Signature (mm/dd/yyyy)

Preparer Certification
Provide the following information concerning the preparer:
7.

8.

Preparer's Name and Contact Information
A.

Preparer's Family Name (Last Name)

B.

Preparer's Business or Organization
Name

Preparer's Given Name (First Name)

Address

Telephone Number

Fax Number

E-mail Address

Preparer's Statement, Certification, and Signature
By my signature, I certify, swear or affirm, under penalty of perjury, that I prepared this form on behalf of, at the request of, and
with the express consent of the registrant (applicant). I completed the form based only on responses the registrant (applicant)
provided to me. After completing the form, I reviewed it and all of the registrant's (applicant's) responses with the registrant
(applicant), who agreed with every answer on the form. If the registrant (applicant) supplied additional information concerning
a question on the form, I recorded it on the form.
Preparer's Signature

Date of Signature (mm/dd/yyyy)

Additional Preparer's Signature (if applicable)

Date of Signature (mm/dd/yyyy)

Form I-590 Edition 08/10/22

Page 9 of 16

Family Name:

A-

RSC Case #:

Part 11. Admissibility
1.

Have you EVER been arrested or have you EVER committed, or helped someone else commit, any crimes?

Yes

No

DRAFT
NOT FOR
PRODUCTION
10/17/2023

If "Yes," have you EVER:
A.

Knowingly committed any crime (excluding traffic violations) for which you have not been
arrested?

Yes

No

B.

Been arrested, cited, charged, indicted, fined, or imprisoned for breaking or violating any law or
ordinance (excluding traffic violations)?

Yes

No

C.

Been the beneficiary of a pardon, amnesty, rehabilitation decree or other act of clemency or
similar action?

Yes

No

D.

Exercised diplomatic immunity to avoid prosecution for a criminal offense in the United States?

Yes

No

E.

Illegally trafficked (illegally transported, traded, dealt, or sold) in any illegal narcotic or other
controlled substance, or knowingly assisted, abetted or conspired in the illicit trafficking of any
such substance?

Yes

No

F.

Engaged in any unlawful commercialized vice, including, but not limited to, illegal gambling?

Yes

No

G.

Knowingly encouraged, induced, assisted, abetted, or aided any alien to try to enter the United
States illegally?

Yes

No

H.

Within the past 10 years, been a prostitute or procured anyone for prostitution?

Yes

No

Provide details of all violations of law on continuation page, if not previously recorded in Part 9 of this form, including: date,
place, nature of charges, and final disposition, for each incident.
2.

Have you EVER been to the United States?

Yes

No

If "No," proceed to Item Number 3. below.
If "Yes," have you EVER:

3.

A.

Been subject to deportation or removal from the United States?

Yes

No

B.

Voted illegally in the United States?

Yes

No

C.

Been a citizen of the United States who has renounced that citizenship to avoid taxation?

Yes

No

D.

Left the United States to avoid being drafted into the U.S. armed forces?

Yes

No

E.

Been subject to a civil document fraud final order for violating section 274C of the
Immigration and Nationality Act of the United States?

Yes

No

Yes

No

Have you EVER applied for a U.S. immigration benefit, such as a visa, refugee status, or asylum?
If "Yes," provide information below
Date (mm/dd/yyyy)

Location

Type of Immigration Benefit

Status (status
Were you the
granted or denied) principal applicant?

4.

Are you now withholding custody of a United States citizen child from a person granted custody of
the child?

5.

Have you EVER:
A.

Engaged in, conspired to engage in, or incited, sabotage, kidnapping, political assassination,
hijacking, or any other form of terrorist activity?

Form I-590 Edition 08/10/22

Yes

No

Yes

No

Yes

No

Yes

No

Page 10 of 16

Family Name:

A-

RSC Case #:

Part 11. Admissibility (continued)
B.

Solicited membership or funds for, or EVER voluntarily assisted or provided any type of
material support to, any person or organization that has EVER engaged in or conspired to
engage in sabotage, kidnapping, political assassination, hijacking, or any other form of terrorist
activity?

Yes

No

C.

Provided support, including housing, transportation, communications, funds, documents,
weapons or training for any person or organization that has EVER engaged in or conspired to
engage in sabotage, kidnapping, assassination, hijacking, or any other form of terrorist activity?

Yes

No

D.

Been a representative or member of any terrorist organization or a member of a group that
endorses terrorist activity?

Yes

No

DRAFT
NOT FOR
PRODUCTION
10/17/2023

6.

If married, has your spouse EVER engaged in terrorist activity or been a member of a
terrorist organization?

Yes

No

N/A

7.

If you are under 21 years of age, has your parent EVER engaged in terrorist activity or
been a member of a terrorist organization?

Yes

No

N/A

8.

While in the United States, do you intend to engage in:

9.

A.

Espionage?

Yes

No

B.

Terrorism or any activity, a purpose of which is opposition to, or the control or overthrow of
the Government of the United States, by force, violence or any other unlawful means?

Yes

No

C.

Any activity to violate or evade any law prohibiting the export from the United States of goods,
technology or sensitive information?

Yes

No

D.

Polygamy (simultaneous marriage to more than one spouse)?

Yes

No

E.

Prostitution?

Yes

No

Yes

No

Have you EVER been a member of, or in any way affiliated with, the Communist party or any other
totalitarian party?
If "Yes:"
Your affiliation/level of membership

10.

11.

Beginning Date (mm/dd/yyyy)

Ending Date (mm/dd/yyyy)

Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following:
A.

Acts involving torture or genocide?

Yes

No

B.

Killing any person?

Yes

No

C.

Intentionally and severely injuring any person?

Yes

No

D.

Engaging in any kind of sexual contact or relations with any person who was being forced or
threatened?

Yes

No

E.

Limiting or denying any person's ability to exercise religious beliefs?

Yes

No

Have you EVER:
A.

Served in, been a member of, assisted in, or participated in any military unit, paramilitary unit,
police unit, self-defense unit, vigilante unit, rebel group, guerrilla group, militia or insurgent
organization?

Yes

No

B.

Served in any prison, jail, prison camp, detention facility, labor camp, or any other situation
that involved detaining persons?

Yes

No

C.

Been a member of, assisted in, or participated in any group, unit, or organization of any kind in
which you or other persons used any type of weapon against any person or threatened to do so?

Yes

No

Form I-590 Edition 08/10/22

Page 11 of 16

Family Name:

A-

RSC Case #:

Part 11. Admissibility (continued)

12.

13.

D.

Assisted or participated in selling or providing weapons to any person who to your knowledge
used them against another person, or in transporting weapons to any person who to your
knowledge used them against another person?

Yes

No

E.

Received any type of military, paramilitary, or weapons training?

Yes

No

DRAFT
NOT FOR
PRODUCTION
10/17/2023

Have you EVER:
A.

Recruited, enlisted, conscripted, or used any person under age 15 to serve in or help an armed
force or group?

Yes

No

B.

Used any person under age 15 to take part in hostilities, or to help or provide services to people
in combat?

Yes

No

Have you, by fraud or willful misrepresentation of a material fact, EVER sought to procure, or
procured, a visa, other documentation, or entry into the United States or any other immigration benefit?

Yes

No

Form I-590 Edition 08/10/22

Page 12 of 16

Family Name:

A-

Do not write below this line.

RSC Case #:

For Government use only.

THIS SECTION IS TO BE COMPLETED ONLY IN THE PRESENCE OF THE U.S. GOVERNMENT OFFICIAL
RESPONSIBLE FOR ADJUDICATING THIS REGISTRATION.

DRAFT
NOT FOR
PRODUCTION
10/17/2023

I, the undersigned, do swear or affirm that I know the contents of this registration subscribed by me, including any attached
documents, and that they are true to the best of my knowledge, and that corrections numbered ____ to ____ were made by me or at
my request. Each and every question and instruction on this form was read to me in ____________________, a language in which I
am fluent. I understand each and every question and instruction on this form, as well as my answer to each question. I agree to
report any changes in family composition, such as births, deaths, marriages, divorces and engagements, to the U.S. Government via
the Resettlement Support Center.
(True and Complete Signature of Registrant)
OPTIONAL: I authorize USCIS to release information contained in or pertaining to my application for refugee status to the U.N.
High Commissioner for Refugees, other U.S. Government agencies, and other resettlement countries. I understand that no
information regarding my refugee claim will be shared with the government of the country from which I am seeking refuge. I
understand that I am not required to sign this waiver, and I do so voluntarily.
(True and Complete Signature of Registrant)
Subscribed and sworn to before me by the above named registrant at __________________ on __________________________
(Location)
(Date, mm/dd/yyyy)
RE-INTERVIEW (if applicable): I, the undersigned, hereby reaffirm the contents of this registration and my answers to every
question on this form, as well as the answers I have provided in my interview on this date.
(True and Complete Signature of Registrant)
Subscribed and sworn to before me by the above named registrant at __________________ on __________________________
(Location)
(Date, mm/dd/yyyy)
Interpreter's Certification and Signature

I certify that: I am fluent in English the same language provided in Part 10., Item B. in Item Number 1.; I have read to this
registrant every question and instruction on this form, as well as the answer to every question, in the language provided in Part 10.,
Item B. in Item Number 1.; and the registrant has informed me that he or she understands every instruction and question on the form,
as well as the answer to every question, and the registrant verified the accuracy of every answer.
1.

Name of Interpreter

2.

Signature of Interpreter

3.

Name of Interpreter (Re-interview)

4.

Signature of Interpreter (Re-interview)

6.

Name, Title, and Signature of Interviewing Officer
(Re-interview)

Interviewing Officer Signature
5.

Name, Title, and Signature of Interviewing Officer

Form I-590 Edition 08/10/22

Page 13 of 16

Family Name:

A-

RSC Case #:

Part 12. Additional Information About Your Registration for Classification as Refugee
Continuation Sheet

DRAFT
NOT FOR
PRODUCTION
10/17/2023

If you need extra space to provide any additional information within this form, use the space below. If you need more space than what
is provided, you may make copies to complete and file with this form or attach a separate sheet of paper. Include your name, your
Alien Registration Number (A-Number) (if any) and RSC Case Number (if any) at the top of each sheet; indicate the Page Number,
Part Number, and Item Number to which your answer refers; and sign and date each sheet.
1.a. Page Number

1.d.

2.a. Page Number

2.d.

3.a. Page Number

1.b. Part Number

1.c. Item Number

2.b. Part Number

2.c. Item Number

3.b. Part Number

3.c. Item Number

4.b. Part Number

4.c. Item Number

3.d.

4.a. Page Number

4.d.

Registrant's (Applicant's) Signature

Form I-590 Edition 08/10/22

Date of Signature (mm/dd/yyyy)

Page 14 of 16

Family Name:

A-

RSC Case #:

Instructions
How To Fill Out Form I-590

DRAFT
NOT FOR
PRODUCTION
10/17/2023

1.

Type or print legibly in black ink.

2.

If you need extra space to complete any item within this form, use the space provided in Part 12. Additional Information
About Your Registration for Classification as Refugee Continuation Sheet. Type or print the registrant's name and Alien
Registration Number (A-Number) (if any) and Resettlement Support Center ("RSC") Case Number (if any) at the top of each
continuation sheet; indicate the Page Number, Part Number, and Item Number to which the answer refers.

3.

Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been married and
the question asks, "Provide the name of your current spouse"), type or print "N/A," unless otherwise directed. If your answer to
a question which requires a numeric response is zero or none (for example, "How many children do you have" or “How many
times have you departed the United States"), type or print "None," unless otherwise directed.

4.

If you do not completely fill out this form or fail to submit required documents listed in the Instructions and your biometrics, if
required, processing of your request will be delayed, and USCIS may reject, close, or deny your form.

5.

Signature. Each form must be properly signed. For all signatures on this form, USCIS will not accept a stamped or typewritten
name in place of a signature. If you are under 14 years of age, your parent or legal guardian may sign the form on your behalf.
A legal guardian may also sign for a mentally incompetent person.

6.

Biometrics. You may be required, to provide fingerprints, photograph, and/or additional signature to verify your identity,
obtain additional information, and conduct background and security checks, including a check of criminal history records. You
will be informed when and where you will need to provide these biometrics. If you fail to provide these biometrics as requested,
USCIS may reject, close, or deny your form.

7.

Requests for More Information. We may request that you provide more information or evidence to support your form. You
may submit legible photocopies of documents requested, unless the Instructions specifically state that you must submit an
original document. USCIS may request an original document at the time of filing or at any time during processing of your form.
If you submit original documents when not required, the documents may be destroyed or remain a part of the record, and USCIS
will not automatically return them to you.

8.

Translations. If you submit a document with information in a foreign language, you must also submit a full English translation.
The translator must sign a certification that the English language translation is complete and accurate, and that he or she is
competent to translate from the foreign language into English. The certification must include the translator's signature. USCIS
recommends the certification contain the translator's printed name and the date and the translator's contact information.
Translations prepared and signed by an RSC employee working for the U.S. Department of State or under contract will be
considered as complete and accurate.

Submission of Form - The RSC with jurisdiction in the registrant's region shall assist the registrant in the completion and submission
of Form I-590, Registration for Classification as Refugee.
Registration - A separate Form I-590 is required for each registrant. Form I-590 on behalf of a child under 14 years of age may be
submitted by the parent or guardian.

SSA Privacy Act Statement
Sections 205(c) and 702 of the Social Security Act, as amended, allow SSA to collect your information, which SSA will use to assign
a Social Security Number (SSN) and issue a Social Security card. Providing this information is voluntary, but not providing all or part
of the information may prevent SSA from assigning an SSN and issuing a Social Security card. As law permits, SSA may use and
share the information you submit, including with other Federal agencies, contractors, employers, and others, as outlined in the routine
uses within System of Records Notice (SORN) 60-0058, available at www.ssa.gov/privacy. The information you submit may also be
used in computer matching programs to establish or verify eligibility for Federal benefit programs and to recoup debts under these
programs.

DHS Privacy Notice
AUTHORITIES: The information requested on this application, and the associated evidence, is collected pursuant to 8 U.S.C.
1522(b) and 8 U.S.C. 1157.

Form I-590 Edition 08/10/22

Page 15 of 16

PURPOSE: The primary purpose for providing the requested information on this application is to determine eligibility for refugee
classification and resettlement in the United States. DHS uses the information you provide to grant or deny the immigration benefit
you are seeking.

DRAFT
NOT FOR
PRODUCTION
10/17/2023

DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, including your
Social Security number (if applicable), and any requested evidence, may delay a final decision or result in the denial of your
application.
ROUTINE USES: DHS may, where allowable under relevant confidentiality provisions, share the information you provide on this
application and any additional requested evidence with other Federal, state, local, and foreign government agencies and authorized
organizations. DHS follows approved routine uses described in the associated published system of records notices [DHS/USCIS/ICE/
CBP-001 - Alien File, Index, and National File Tracking System, DHS/USCIS-017 - Refugee Case Processing and Security Screening
Information, DHS/USCIS-018 - Immigration Biometric and Background Check and the STATE-59 - Refugee Case Records] and as
described in the Privacy Impact Assessments [DHS/USCIS/PIA-068 Refugee Case Processing and Security Vetting PIA and DOS
Refugee Processing Center - General Support System (RPC - GSS)], which can be found at www.dhs.gov/privacy and
www.state.gov. DHS may also share this information, as appropriate, for law enforcement purposes or in the interest of national
security.

Paperwork Reduction Act

An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection of information
unless it displays a currently valid OMB control number. The public reporting burden for Form I-590 is estimated at 3 hours for
gathering information; 20 minutes (.33 hours) for submitting biometric information; 1 hour for review the request; and 2 hours for
collecting DNA evidence (if applicable). Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Office of Policy and
Strategy, Regulatory Coordination Division, 5900 Capital Gateway Drive, Mail Stop #2140, Camp Springs, MD 20588-0009; OMB No
1615-0068. Do not mail your completed Form I-590 to this address.

Form I-590 Edition 08/10/22

Page 16 of 16