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I-589, Application For Asylum and For Withholding of Removal

Gustavo Adolfo Lopez Suarez submitted an I-589 application for asylum and withholding of removal on August 16, 2023, citing his fear of persecution in Venezuela. He currently resides in Charlotte, NC, with his spouse, Katty Mariela Canelon Guzman, and their two children, all of whom entered the U.S. on the same date. The application includes detailed personal information, background, and reasons for seeking asylum due to conditions in Venezuela.

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0% found this document useful (0 votes)
29 views12 pages

I-589, Application For Asylum and For Withholding of Removal

Gustavo Adolfo Lopez Suarez submitted an I-589 application for asylum and withholding of removal on August 16, 2023, citing his fear of persecution in Venezuela. He currently resides in Charlotte, NC, with his spouse, Katty Mariela Canelon Guzman, and their two children, all of whom entered the U.S. on the same date. The application includes detailed personal information, background, and reasons for seeking asylum due to conditions in Venezuela.

Uploaded by

anapaulalopez560
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 12

Department of Homeland Security

U.S. Citizenship and Immigration Services


U.S. Department of Justice
Executive Office for Immigration Review

I-589, Application for Asylum and for Withholding of Removal


Applicant: GUSTAVO ADOLFO LOPEZ SUAREZ
Submission Date: 2023-08-16T20:05:49UTC
Do you also want to apply for withholding of removal under the Convention Against Torture?: Yes

Part A.I. Information About You


1. Alien Registration Number(s) (A-Number) (if any):
2. U.S. Social Security Number (if any):
3. USCIS Online Account Number (if any):
4. Complete Last Name: LOPEZ SUAREZ
5. First Name: GUSTAVO
6. Middle Name: ADOLFO
7. What other names have you used (include maiden name and aliases)?
8. Residence in the U.S. (where you physically reside)
Street Number and Name: 5017 SHADBUSH RD
Apt. Number:
City: CHARLOTTE
State: NC
ZIP Code: 28215-6704
Telephone Number: 704-521-0468
9. Mailing Address in the U.S. (if different than the address in Item Number 8)
In Care of (if applicable): LOPEZ SUAREZ GUSTAVO ADOLFO
Telephone Number: 704-521-0468
Street Number and Name: 5017 SHADBUSH RD
Apt. Number:
City: CHARLOTTE
State: NC
ZIP Code: 28215-6704
10. Gender (Male, Female): Male
11. Marital Status (Single, Married, Divorced, Widowed): married
12. Date of Birth (mm/dd/yyyy): 09-19-1968
13. City and Country of Birth:
City: ACARIGUA PORTUGUESA
Country: VEN
14. Present Nationality (Citizenship): VEN
15. Nationality at Birth: VEN
16. Race, Ethnic, or Tribal Group: HISPANIC
17. Religion: CATHOLIC
18.a. I have never been in Immigration Court proceedings.: Yes
18.b. I am now in Immigration Court proceedings:
18.c. I am not now in Immigration Court proceedings, but I have been in the past:

Page 1 of 12 Form I-589 Edition 03/01/23


19.a. When did you last leave your country? (mm/dd/yyyy): 07-24-2023
Last Left Your Country Other:
19.b. What is your current I-94 Number, if any?: 459376895A3
19.c. List each entry into the U.S. beginning with your most recent entry. List date (mm/dd/yyyy), place, and your status for each
entry. (Attach additional sheets as needed.)
Most Recent Entry Record:
Date of Entry: 07-24-2023
Place of Entry: MIA
Other Place of Entry:
Status: B2
Date Status Expires: 01-23-2024
Previous Entry Record(s):
Date of Entry: 03-09-2022
Place of Entry: MIA
Other Place of Entry:
Status: B2
20. What country issued your last passport or travel document?: VEN
21. Passport/Travel Document Number: 161359153
22. Expiration Date (mm/dd/yyyy): 09-06-2031
23. What is your native language (include dialect, if applicable)?: SP
24. Are you fluent in English?: No
25. What other languages do you speak fluently?

Part A.II. Information About Your Spouse and Children


Your spouse
1. Alien Registration Number (A-Number) (if any):
2. Passport/ID Card Number (if any): 161357711
3. Date of Birth (mm/dd/yyyy): 04-20-1976
4. U.S. Social Security Number (if any):
5. Complete Last Name: CANELON GUZMAN
6. First Name: KATTY
7. Middle Name: MARIELA
8. Other names used (include maiden name and aliases)
9. Date of Marriage (mm/dd/yyyy): 12-10-2008
10. Place of Marriage: MARACAY ESTADO ARAGUA
11. City and Country of Birth:
City: MARACAY ARAGUA
Country: VEN
12. Nationality (Citizenship): VEN
13. Race, Ethnic, or Tribal Group: HISPANIC
14. Gender (Male,Female): Female
15. Is this person in the U.S.? "Yes " (Complete Blocks 16 to 24). "No" (Specify location) : Yes
Spouse Location:
16. Place of last entry into the U.S.: MIA
Other Place of Last Entry:

Page 2 of 12 Form I-589 Edition 03/01/23


17. Date of last entry into the U.S. (mm/dd/yyyy): 07-24-2023
18. I-94 Number (if any): 459382249A3
19. Status when last admitted (Visa type, if any): B2
20. What is your spouse's current status?: B2
21. What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy): 01-23-2024
22. Is your spouse in Immigration Court proceedings?: No
23. If previously in the U.S., date of previous arrival (mm/dd/yyyy): 03-09-2022
24. If in the U.S., is your spouse to be included in this application?: Yes
Your Children. List all of your children, regardless of age, location, or marital status.
I have children: Yes
Total number of children: 2

1. Alien Registration Number (A-Number) (if any):


2. Passport/ID Card Number (if any): 176900560
3. Marital Status (Single, Married, Divorced, Widowed): single
4. U.S. Social Security Number (if any):
5. Complete Last Name: LOPEZ CANELON
6. First Name: ANAPAULA
7. Middle Name: NA
8. Date of Birth (mm/dd/yyyy): 05-31-2012
9. City and Country of Birth:
City: MARACAY ARAGUA
Country: VEN
10. Nationality (Citizenship): VEN
11. Race, Ethnic, or Tribal Group: HISPANIC
12. Gender (Male,Female): Female
13. Is this child in the U.S. ?: Yes
Child Location:
14. Place of last entry into the U.S.: MIA
Other Place of Last Entry:
15. Date of last entry into the U.S. (mm/dd/yyyy): 07-24-2023
16. I-94 Number (If any): 459383248A3
17. Status when last admitted (Visa type, if any): B2
18. What is your child's current status?: B2
19. What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy): 01-23-2024
20. Is your child in Immigration Court proceedings?: No
21. If in the U.S., is this child to be included in this application?: Yes
1. Alien Registration Number (A-Number) (if any):
2. Passport/ID Card Number (if any): 161357643
3. Marital Status (Single, Married, Divorced, Widowed): single
4. U.S. Social Security Number (if any):
5. Complete Last Name: LOPEZ CANELON
6. First Name: ALANIS
7. Middle Name: ANDREA
8. Date of Birth (mm/dd/yyyy): 09-02-2008
9. City and Country of Birth:

Page 3 of 12 Form I-589 Edition 03/01/23


City: MARACAY ESTADO ARAGUA
Country: VEN
10. Nationality (Citizenship): VEN
11. Race, Ethnic, or Tribal Group: HISPANIC
12. Gender (Male,Female): Female
13. Is this child in the U.S. ?: Yes
Child Location:
14. Place of last entry into the U.S.: MIA
Other Place of Last Entry:
15. Date of last entry into the U.S. (mm/dd/yyyy): 07-24-2023
16. I-94 Number (If any): 459381753A3
17. Status when last admitted (Visa type, if any): B2
18. What is your child's current status?: B2
19. What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy): 01-23-2024
20. Is your child in Immigration Court proceedings?: No
21. If in the U.S., is this child to be included in this application?: Yes

Part A.III. Information About Your Background


1. List your last address where you lived before coming to the United States. If this is not the country where you fear persecution,
also list the last address in the country where you fear persecution. (List Address, City/Town, Department, Province, or State and
Country.)
Number and Street, Line 1 (Provide if Available): URB SAN PABLO CALLE HICELE N-16-2
Number and Street, Line 2 (Provide if Available):
City/Town: TURMERO
Department, Province, or State: ARAGUA
State:
Zip Code:
Postal Code:
Country: VEN
Dates: From (Month): 09
Dates: From (Year): 1968
Dates: To (Month): 07
Dates: To (Year): 2023

2. Provide the following information about your residences during the past 5 years. List your present address first.
Number and Street, Line 1: URB SAN PABLO CALLE HICELE N-16-2
Number and Street, Line 2:
City/Town: TURMERO
Department or Province: ARAGUA
State:
Postal Code:
ZIP Code:
Country: VEN
Dates:From(Month): 09
Dates:From(Year): 1968
Dates:To(Month): 07
Dates:To(Year): 2023

Page 4 of 12 Form I-589 Edition 03/01/23


Number and Street, Line 1: 5017 SHAD BUSH RD
Number and Street, Line 2:
City/Town: CHARLOTTE
Department or Province:
State: NC
Postal Code:
ZIP Code: 28215
Country: USA
Dates:From(Month): 07
Dates:From(Year): 2023
Dates:To(Month):
Dates:To(Year):

3. Provide the following information about your education, beginning with the most recent school that you attended.
Name of School: UNELLEZ
Type of School: UNIVERSITY
Location (Address):
Street Name and Number: SAN CARLOS EDO COJEDES
Apt. No.:
City: SAN CARLOS
State:
ZIP Code:
Province: COJEDES
Postal Code:
Country: VEN
Dates:From(Month): 09
Dates:From(Year): 1987
Dates:To(Month): 07
Dates:To(Year): 1993
Name of School: LICEO JOSE ANTONIO PAEZ
Type of School: HIGH SCHOOL
Location (Address):
Street Name and Number: ACARIGUA PORTUGUESA
Apt. No.:
City: ACARIGUA
State:
ZIP Code:
Province: PORTUGUESA
Postal Code:
Country: VEN
Dates:From(Month): 10
Dates:From(Year): 1980
Dates:To(Month): 07
Dates:To(Year): 1985
Name of School: ESCUELA CIUDAD ACARIGUA
Type of School: MIDDLE SCHOOL

Page 5 of 12 Form I-589 Edition 03/01/23


Location (Address):
Street Name and Number: ACARIGUA ESTADO PORTUGUESA
Apt. No.:
City: ACARIGUA
State:
ZIP Code:
Province: PORTUGUESA
Postal Code:
Country: VEN
Dates:From(Month): 09
Dates:From(Year): 1979
Dates:To(Month): 07
Dates:To(Year): 1985

4. Provide the following information about your employment during the past 5 years. List your present employment first.
Name and Address of Employer: ECOLAB
Street Name and Number: CARACAS VENEZUELA
Apt. No.:
City: CARACAS
State:
ZIP Code:
Province: DISTRITO CAPITAL
Postal Code:
Country: VEN
Your Occupation: ACCOUNT MANAGER
Dates:From(Month): 09
Dates:From(Year): 2000
Dates:To(Month): 08
Dates:To(Year): 2023

5. Provide the following information about your parents and siblings (brothers and sisters). Check the box if the person is deceased.
Relationship (Mother, Father, Sibling): Father
First Name: JUAN
Last Name: LOPEZ LOPEZ
Middle Name: BAUTISTA
City/Town of Birth: BARQUISIMETO ESTADO LARA
Country of Birth: VEN
Current Location:
Deceased: Yes
Relationship (Mother, Father, Sibling): Mother
First Name: MARIA
Last Name: SUAREZ DE LOPEZ
Middle Name: LOURDES
City/Town of Birth: BARQUISIMETO ESTADO LARA
Country of Birth: VEN
Current Location: ACARIGUA VENEZUELA
Deceased:

Page 6 of 12 Form I-589 Edition 03/01/23


Relationship (Mother, Father, Sibling): Sibling
First Name: JUAN
Last Name: LOPEZ SUAREZ
Middle Name: ENRRIQUE
City/Town of Birth: ACARIGUA VENEZUELA
Country of Birth: VEN
Current Location: ACARIGUA VENEZUELA
Deceased:
Relationship (Mother, Father, Sibling): Sibling
First Name: YADITZA
Last Name: LOPEZ SUAREZ
Middle Name: MICAELA
City/Town of Birth: ACARIGUA VENEZUELA
Country of Birth: VEN
Current Location: LIMA PERU
Deceased:
Relationship (Mother, Father, Sibling): Sibling
First Name: YANIS
Last Name: LOPEZ SUAREZ
Middle Name: CATALINA
City/Town of Birth: ACARIGUA VENEZUELA
Country of Birth: VEN
Current Location: ACARIGUA VENEZUELA
Deceased:

Part B. Information About Your Application


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.
:
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? I am seeking asylum or withholding of removal based on:
Race:
Religion:
Nationality:
Political Opinion: Yes
Membership in a particular social group: Yes
Torture Convention: Yes
A. Have you, your family, or close friends or colleagues ever experienced harm or mistreatment or threats in the past by anyone?:
Yes
If "Yes," explain in detail: 1. What happened; 2. When the harm or mistreatment or threats occurred; 3. Who caused the harm or
mistreatment or threats; and 4. Why you believe the harm or mistreatment or threats occurred.: At half past six in the afternoon
we took the bus back for approximately two hours until we arrived again to Turmero, the bus stops at the corner of the Valle Lindo
shopping center which is located about seven blocks from my house and I proceed to walk down the street number 1 and it was
approximately 8:30 pm when I have advanced approximately three blocks: 30 pm when I have advanced approximately three

Page 7 of 12 Form I-589 Edition 03/01/23


blocks finding the street totally alone and dark very close to the building where the Mayor's Office of Turmero works suddenly
appeared a black motorcycle of high cylinder capacity that stopped next to me with two men on board, whom I had never seen,
they were dressed in black whose shirts had the following letters FBL that identifies a Venezuelan guerrilla group that call
themselves Bolivarian Liberation Forces (fuerzas bolivarianas de liberacin), Quickly the man who was the co-pilot got off the
motorcycle, took a knife out of his pocket, put it in my side and told me to get on the motorcycle, which I did, and then he got on
behind me, leaving me in the middle of the two men, at that moment neither of them said a word and I remained mute, The
motorcycle headed towards a sports area called the oval that is located at the foot of the hill of the picacho, that took about five
minutes that for me turned out to be an eternity, when we arrived at the Oval we got off the motorcycle and turned it off, the
area was very dark I could barely see their faces; In that place there was a metal shovel and one of them took it and we began to
climb the mountain, my legs were trembling and I felt very scared, the climb took about 15 minutes through tree and mountain
roads, until we reached a clear area where we stopped and they proceeded to hit me in the stomach, I fell to the ground and they
called me by my name Gustavo and told me to start digging a hole, I said NO They hit me again in the stomach and they gave me
the shovel, the ground was very hard and the shovel did not fit or I did not have the strength to dig so the more robust and said
this opposition rat is not even good to open his own hole and so pretends to knock down my president Nicolas Maduro.
B. Do you fear harm or mistreatment if you return to your home country?: Yes
If "Yes," explain in detail: 1. What harm or mistreatment you fear; 2. Who you believe would harm or mistreat you; and 3. Why
you believe you would or could be harmed or mistreated.: At that moment when the two men began to rant about the opponents
of the government I looked up and just thought that if I did not run that would be the end of me and without hesitation I began to
run up without stopping or looking back, thanks that I am an athlete and for many years I have climbed the mountain of Picacho I
could escape and crossing the mountain I arrived at approximately 10:15 pm to my house which is located in the center of the city:
15 pm to my house which is very close to that area, there I told everything to my family and we went to file a complaint at the
Turmero police station at 11:00 pm where the crime committed was classified as AMANZA-DESAPARICION FORCED identified with
the cause K-23-0243-02524. After filing the complaint my family and I returned to our house at approximately 1:00 a.m. where I
suffered a panic attack and none of the family could sleep all night. That Saturday morning I decided to go with my family to the
city of Acarigua Edo Portuguesa where my mother lives to try to calm down a little, which was practically impossible, on Monday
26 we were forced to return to our house in Turmero for each of the members of the family to fulfill their school and work duties, I
for my part remained locked up at home, the following days passed within a tense calm inside my house and my panic attack was
maintained I could not work or even go out beyond the gate of the house

2. Have you or your family members ever been accused, charged, arrested, detained, interrogated, convicted and sentenced, or
imprisoned in any country other than the United States (including for an immigration law violation)?: No
If "Yes," explain the circumstances and reasons for the action:

3.A. Have you or your family members ever belonged to or been associated with any organizations or groups in your home country,
such as, but not limited to, a political party, student group, labor union, religious organization, military or paramilitary group, civil
patrol, guerrilla organization, ethnic group, human rights group, or the press or media?: Yes
If "Yes," describe for each person the level of participation, any leadership or other positions held, and the length of time you or
your family members were involved in each organization or activity.: My family and I have always belonged to the political party
ACCION DEMOCRATICA for which we have always fought for freedom and democracy.

3.B. Do you or your family members continue to participate in any way in these organizations or groups?: No
If "Yes," describe for each person your or your family members' current level of participation, any leadership or other positions
currently held, and the length of time you or your family members have been involved in each organization or group.:

4. Are you afraid of being subjected to torture in your home country or any other country to which you may be returned?: Yes
If "Yes," explain why you are afraid and describe the nature of torture you fear, by whom, and why it would be inflicted.: until
Thursday June 29th. Until Thursday June 29, when at about 11 pm, they ring the doorbell of my house and I proceed to open the
door, thanks to the fact that my house has a gate at the main entrance that prevented the entry of the people who rang the bell, I
look out and see three men in the distance and tell them good night, to which they tell me that they have an arrest warrant
against me, from inside I tell them to show the arrest warrant and tell me to which police agency they belong, One of them
answered that they belonged to the Bolivarian Liberation Forces and that I was wanted for incitement to hatred and treason, at

Page 8 of 12 Form I-589 Edition 03/01/23


that moment he took out a firearm and pointed it towards where I was, I proceeded to close my front door which is a metal
security door and I heard three gunshots, I ran to the second floor of my house to look for my daughters, wife and sister-in-law,
fortunately none of them were hurt. That night we remained locked up, calling the whole family on the phone, without sleeping all
night, but we did not want to call the police, we did not even file a report, since we thought that the security forces are part of
these actions.

Part C. Additional Information About Your Application


1. Have you, your spouse, your child(ren), your parents or your siblings ever applied to the U.S. Government for refugee status,
asylum, or withholding of removal?: No
If "Yes," explain the decision and what happened to any status you, your spouse, your child(ren), your parents, or your siblings
received as a result of that decision. Indicate whether or not you were included in a parent or spouse's application. If so, include
your parent or spouse's A-number in your response. If you were previously denied asylum by USCIS, an immigration judge, or the
Board of Immigration Appeals, describe any change(s) in conditions in your country or your own personal circumstances since the
date of the denial that may affect your eligibility for asylum.:

2.A. After leaving the country from which you are claiming asylum, did you or your spouse or child(ren) who are now in the United
States travel through or reside in any other country before entering the United States?: No
If "Yes," , provide for each person the following: the name of each country and the length of stay, the person's status while there,
the reasons for leaving, whether or not the person is entitled to return for lawful residence purposes, and whether the person
applied for refugee status or for asylum while there, and if not, why he or she did not do so:

2.B. Have you, your spouse, your child(ren), or other family members, such as your parents or siblings, ever applied for or received
any lawful status in any country other than the one from which you are now claiming asylum?: No
If "Yes," , provide for each person the following: the name of each country and the length of stay, the person's status while there,
the reasons for leaving, whether or not the person is entitled to return for lawful residence purposes, and whether the person
applied for refugee status or for asylum while there, and if not, why he or she did not do so:

3. Have you, your spouse or your child(ren) ever ordered, incited, assisted or otherwise participated in causing harm or suffering to
any person because of his or her race, religion, nationality, membership in a particular social group or belief in a particular political
opinion?: No
If "Yes," describe in detail each such incident and your own, your spouse's, or your child(ren)'s involvement.:

4. After you left the country where you were harmed or fear harm, did you return to that country?: No
If "Yes," describe in detail the circumstances of your visit(s) (for example, the date(s) of the trip(s), the purpose(s) of the trip(s),
and the length of time you remained in that country for the visit(s).):

5. Are you filing this application more than 1 year after your last arrival in the United States?: No
If "Yes," explain why you did not file within the first year after you arrived. You must be prepared to explain at your interview or
hearing why you did not file your asylum application within the first year after you arrived. For guidance in answering this
question, see Instructions, Part 1: Filing Instructions, Section V. "Completing the Form," Part C.:

6. Have you or any member of your family included in the application ever committed any crime and/or been arrested, charged,
convicted, or sentenced for any crimes in the United States (including for an immigration law violation)?: No
If "Yes," for each instance, specify in your response: what occurred and the circumstances, dates, length of sentence received,
location, the duration of the detention or imprisonment, reason(s) for the detention or conviction, any formal charges that were
lodged against you or your relatives included in your application, and the reason(s) for release.If you have been arrested in the
United States, you must submit a certified copy of all arrest reports, court dispositions, sentencing documents, and any other
relevant documents.:

Part D. Your Signature


I certify, under penalty of perjury under the laws of the United States of America, that this application and the evidence submitted
with it are all true and correct. Title 18, United States Code, Section 1546(a), provides in part: Whoever knowingly makes under oath,
or as permitted under penalty of perjury under Section 1746 of Title 28, United States Code, knowingly subscribes as true, any false

Page 9 of 12 Form I-589 Edition 03/01/23


statement with respect to a material fact in any application, affidavit, or other document required by the immigration laws or
regulations prescribed thereunder, or knowingly presents any such application, affidavit, or other document containing any such false
statement or which fails to contain any reasonable basis in law or fact - shall be fined in accordance with this title or imprisoned for
up to 25 years. I authorize the release of any information from my immigration record that U.S. Citizenship and Immigration Services
(USCIS) needs to determine eligibility for the benefit I am seeking.

WARNING: Applicants who are in the United States unlawfully are subject to removal if their asylum or withholding claims are not
granted by an asylum officer or an immigration judge. Any information provided in completing this application may be used as a basis
for the institution of, or as evidence in, removal proceedings even if the application is later withdrawn. Applicants determined to have
knowingly made a frivolous application for asylum will be permanently ineligible for any benefits under the Immigration and
Nationality Act. You may not avoid a frivolous finding simply because someone advised you to provide false information in your
asylum application. If filing with USCIS, unexcused failure to appear for an appointment to provide biometrics (such as fingerprints)
and your biographical information within the time allowed may result in an asylum officer dismissing your asylum application or
referring it to an immigration judge. Failure without good cause to provide DHS with biometrics or other biographical information
while in removal proceedings may result in your application being found abandoned by the immigration judge. See sections 208(d)(5)
(A) and 208(d)(6) of the INA and 8 CFR sections 208.10, 1208.10, 208.20, 1003.47(d) and 1208.20.

Print your complete name: LOPEZ SUAREZ GUSTAVO ADOLFO


Write your name in your native alphabet:
Did your spouse, parent, or child(ren) assist you in completing this application?: No
If "Yes," list the name and relationship.
Did someone other than your spouse, parent, or child(ren) prepare this application? (If "Yes," complete Part E.): No
Asylum applicants may be represented by counsel. Have you been provided with a list of persons who may be available to assist you,
at little or no cost, with your asylum claim?: Yes
Signature Email Address: familialopezcanelon@gmail.com
Signature Date: 08-16-2023
Electronic Filing Record

Part E. Declaration of Person Preparing Form, if Other Than Applicant, Spouse, Parent, or Child
I declare that I have prepared this application at the request of the person named in Part D, that the responses provided are based on
all information of which I have knowledge, or which was provided to me by the applicant, and that the completed application was
read to the applicant in his or her native language or a language he or she understands for verification before he or she signed the
application in my presence. I am aware that the knowing placement of false information on the Form I-589 may also subject me to
civil penalties under 8 U.S.C. 1324c and/or criminal penalties under 18 U.S.C. 1546(a).
Signature Of Preparer:
Date:
Complete Name of Preparer:
First Name:
Last Name:
Daytime Telephone Number:
Address of Preparer
Street Number and Name:
Apt. Number:
City:
State:
ZIP Code:
Province:
Postal Code:
Country:

Attorney State Bar Number (if applicable):


Attorney or Accredited Representative USCIS Online Account Number (if any):

Page 10 of 12 Form I-589 Edition 03/01/23


Evidence
Original File Name: COVER LETTER ASILO ON LINE L_32_-pdffiller.pdf
Category: Cover Letter
Original File Name: History .pdf
Category: Translation Certification
Original File Name: affidavits _compressed.pdf
Category: Affidavits
Original File Name: COMPLAINT 1.pdf
Category: Other Supporting Documents
Original File Name: COMPLAINT 2.pdf
Category: Other Education Documents
Original File Name: COMPLAINT 3.pdf
Category: Other Supporting Documents
Original File Name: PSYCHOLOGICAL CERTIFICATION .pdf
Category: Psychological Report
Original File Name: PSYCHOLOGICAL REPORT.pdf
Category: Psychological Report
Original File Name: POLITICAL PARTICIPATION GUSTAVO LOPEZ .pdf
Category: Affidavits
Original File Name: POLITICAL PARTICIPATION KATTY CANELON .pdf
Category: Other Supporting Documents
Original File Name: photo evidence .pdf
Category: Social Media Posts
Original File Name: photo evidence 2.pdf
Category: Social Media Posts
Original File Name: PASSPORT GUSTAVO LOPEZ .pdf
Category: Passport
Original File Name: BIRTH CERTIFICATE GUSTAVO LOPEZ .pdf
Category: Birth Records
Original File Name: VISA GUSTAVO LOPEZ .JPG
Category: Visa
Original File Name: MARRIAGE CERTIFICATE .pdf
Category: Marriage Certificate
Original File Name: PASSPORT KATTY CANELON .pdf
Category: Passport
Original File Name: BIRTH CERTIFICATE KATTY CANELON .pdf
Category: Birth Records
Original File Name: VISA KATTY CANELON .JPG
Category: Visa
Original File Name: PASSPORT ALANIS LOPEZ _compressed (1).pdf
Category: Passport
Original File Name: BIRTH CERTIFICATE ALANIS LOPEZ .pdf
Category: Birth Records

Page 11 of 12 Form I-589 Edition 03/01/23


Original File Name: VISA DE ALANIS LOPEZ .JPG
Category: Visa
Original File Name: PASSPORT ANA PAULA LOPEZ .pdf
Category: Passport
Original File Name: BIRTH CERTIFICATE ANAPAULA LOPEZ .pdf
Category: Birth Records
Original File Name: VISA DE ANAPAULA LOPEZ .JPG
Category: Visa
Original File Name: World Report 2023_ Venezuela _ Human Rights Watch.pdf
Category: Country Conditions Information
Original File Name: Venezuela 2023- United States Department of State.pdf
Category: News Article
Original File Name: Torture in the Heart of Venezuela _ The Nation.pdf
Category: News Article
Original File Name: anexo 2022 venezuela (1)_compressed.pdf
Category: Other Supporting Documents

Supplement B, Form I-589


Additional Information About Your Claim to Asylum

Page 12 of 12 Form I-589 Edition 03/01/23

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