Bailey Immigration

Asylum Form

Name:

Address:

City:State:Zip Code:

Phone:

Work Phone:Email:

Nationality:Age:Birth Date:

How did you hear about us?

When did you enter the U.S.?:

With what kind of visa, if any, did you enter the U.S.? :

Has your authorization in the U.S. expired? If yes, when?

Have you already applied for asylum at the asylum office?

Are you currently in deportation/removal proceedings?

What country are you from? Do you fear returning to your country?

Please provide a detailed description of your case below:

Have you ever been convicted of a misdameanor or a felony?

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This website provides general immigration information only. Please see our disclaimer. For all situations, you should contact an immigration attorney for legal advice.