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Get DS-234 Special Immigrant Visa Biodata 2017

DS-234 03-2016 Submit one copy of the Special Immigrant Visa Biodata form for each family member. Send completed form s to the National Visa Center as an email attachment at NVCSIV state. U*S* Department of State OMB APPROVAL NO. 1405-0203 EXPIRES 03-31-2019 ESTIMATED BURDEN 20 MIN* Bureau of Population Refugees and Migration SPECIAL IMMIGRANT VISA BIODATA FORM Special immigrant visa applicants who qualify for and request resettlement assistance from the Department of State must complete this form for each family member and submit it via email as a scanned attachment to the National Visa Center at NVCSIV state. gov. A. CASE INFORMATION To be completed by NVC NVC Case Number Assigned Post Post POC Information 2. Are you the principal applicant PA 3. If not what is your relationship to the PA Husband wife son daughter B. CASE MEMBER 1. Case Size Yourself plus family members traveling with you Yes No 4. Name as it Appears on your Passport Last First Middle 5. Sex Male 6. Marital Status 7. Date of Birth mm-dd-yyyy 8. Place of Birth City Country 9. Nationality 10. Ethnicity 11. Religion Female 12. Physical Address 13. Phone Number s 14. E-mail 15. Occupation/Skill 16. Education Level/Field of Study 17. Native Language 18. Other Language s 19. English Speaking Ability Good Some None 20. Pregnant Estimated Delivery Date EDD mm/dd/yyyy Select 20. Health Issues If yes please explain C. CROSS REFERENCE 21. Do you have other immediate family members being processed on their own special immigrant visas If yes please provide your family member s name relationship to you and special immigrant visa case number. gov. Page 1 of 2 Family Member Name Last First Middle Relationship to you dd mmm yyyy If unknown check box D. U*S* TIES 22. Do you have family members or friends already residing in the United States If yes please provide family/friend information below. It may be possible to be resettled near them* If the number exceeds 7 please include them in the comments section* Name Address E-mail Address E* COMMENTS CONFIDENTIALITY STATEMENT AND PAPERWORK REDUCTION ACT STATEMENT The information asked for on this form is requested in accordance with Section 222 f of the Immigration and Nationality Act and is considered confidential* The information provided herein shall only be shared with State Department personnel officers of other federal agencies including the Department of Health and Human Services and the Department of Homeland Security and resettlement agency employees on a need to know basis. The U*S* Department of State uses the facts you provide on this form to facilitate the provision of Resettlement and Placement benefits and to assist in determining the location in the United States in which you will be resettled* Public reporting burden for this collection of information is estimated to average 20 minutes per response including time required for searching existing data sources gathering the necessary documentation providing the information and/or documents required and reviewing the final collection* You do not have to supply this information unless this collection displays a currently valid OMB control number.

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