Apply for asylum or protection | JRICKSS Financial Services LLC

Your information

Same name as on travel documents.

First name*This field is required.

Last name*This field is required.

Other namesThis field is required.

Date of birth*This field is required.

City of birth*This field is required.

Country of birth*This field is required.

Nationality*This field is required.

Sex*This field is required.

Race / Ethnic groupThis field is required.

Marital status*This field is required.

A-Number if anyThis field is required.

Social Security Number if anyThis field is required.

Passport numberThis field is required.

Native language*This field is required.

Other languages spokenThis field is required.

Your entry to the US

When and how you arrived. The 1 year filing deadline starts the day you entered.

Date of last entry*This field is required.

Place of entry*This field is required.

Status when you enteredThis field is required.

I-94 numberThis field is required.

Visa used to enterThis field is required.

Current statusThis field is required.

Authorized stay expiration dateThis field is required.

Have you been in the US before this entry?This field is required.

Do you have removal or deportation proceedings pending or an order of removal?This field is required.

Have you applied for asylum in the US before?This field is required.

Have you applied for protection in any other country?This field is required.

Current US address*This field is required.

Phone*This field is required.

Email*This field is required.

Family with you

Spouse, children, parents who are with you in the US or you want to include.

Spouse full nameThis field is required.

Spouse DOBThis field is required.

Spouse country of birthThis field is required.

Spouse in US?This field is required.

Include spouse in this application?This field is required.

Marriage dateThis field is required.

Why you fear returning

Pick the basis. You can pick more than one.

Race*

YesNo

Please answer.

Religion*

YesNo

Please answer.

Nationality*

YesNo

Please answer.

Political opinion*

YesNo

Please answer.

Particular social group (LGBTQ, family-based, gender-based, etc.)*

YesNo

Please answer.

Convention Against Torture*

YesNo

Please answer.

Country where you fear persecution*This field is required.

What happened to you

Tell us as much as you can. Even a few sentences. We will help you write the full declaration later.

Were you harmed or threatened before you left?*

YesNo

Please answer.

Who harmed or threatened you?This field is required.

When did the persecution start?This field is required.

In your own words, what happened or what you fear*This field is required.

Were any family members also harmed or threatened for the same reasons?

YesNo

Please answer.

Did you return to your home country after the events you described?

YesNo

Please answer.

Could you safely live in another part of your country?*

YesNo

Please answer.

Documents and submit

Upload anything that supports your case.

Upload

Examples: passport, ID, police reports, medical records, threats received, news articles about your situation, photos of injuries, witness letters.

Review and submit

Look over the information you gave us. Click Edit on any section to change it. When ready, click Submit.

Goes straight to [email protected]. We acknowledge within 24 hours.