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Sample completed asylum application Form 1598, to use for example purposes only. Download. Full Declaration: 1.I was born in XXX into a Christian family and have always practiced the religion. ASYLUM - Sample Form I-589 DV One Year Bar. Sign up to our newsletter to learn more about people forced to flee and how you can support them. Subscribe. You must complete all fields that are relevant to your application;. 2. Failure to disclose all necessary information or to provide false information about. What is the Convention Against Torture, or "CAT? Your asylum application will ask for a personal statement—also called your asylum story. To whom it may concern: I am a pro se applicant for asylum in the United States.