Form I-589 - Application For Asylum And For Withholding Of Removal Page 5

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Part B. Information About Your Application

(NOTE: Use Form I-589 Supplement B, or attach additional sheets of paper as needed to complete your responses to the questions contained in

Part B.)

When answering the following questions about your asylum or other protection claim (withholding of removal under 241(b)(3) of the INA or

withholding of removal under the Convention Against Torture), you must provide a detailed and specific account of the basis of your claim to asylum

or other protection. To the best of your ability, provide specific dates, places, and descriptions about each event or action described. You must attach

documents evidencing the general conditions in the country from which you are seeking asylum or other protection and the specific facts on which

you are relying to support your claim. If this documentation is unavailable or you are not providing this documentation with your application, explain

why in your responses to the following questions.

Refer to Instructions, Part 1: Filing Instructions, Section II, "Basis of Eligibility," Parts A - D, Section V, "Completing the Form," Part B, and Section

VII, "Additional Evidence That You Should Submit," for more information on completing this section of the form.

1. Why are you applying for asylum or withholding of removal under section 241(b)(3) of the INA, or for withholding of removal under the

Convention Against Torture? Check the appropriate box(es) below and then provide detailed answers to questions A and B below.

I am seeking asylum or withholding of removal based on:

Race

Political opinion

Religion

Membership in a particular social group

Nationality

Torture Convention

A. Have you, your family, or close friends or colleagues ever experienced harm or mistreatment or threats in the past by anyone?

Yes