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USCIS I-643 Immigration Form

USCIS I-643

 

Health and Human Services Statistical Data for Refugee/Asylee Adjusting Status USCIS Form ( I-643 )

Title	Health and Human Services Statistical Data for Refugee/Asylee Adjusting Status
Number	I-643
Official URL	http://www.uscis.gov/I-643
Fee	None
Mailing Address	The Immigration Officer assisting you with this form will submit it to: Data Unit, Office of Refugee Resettlement Department of Health and Human Services 370 L'Enfant Promenade S.W. (6th Floor) Washington, DC 20447
Edition	5/19/06. Versions other than the 5/19/06 edition are not acceptable.
PDF Downloads	I-643

 

 

Health and Human Services Statistical Data for Refugee/Asylee Adjusting Status

Purpose of Form :

This form is used to provide statistical data to the Department of Health and Human Services regarding refugees or asylees who wish to adjust to immigrant status in the United States.

Number of Pages :

2

Edition Date :

5/19/06. Versions other than the 5/19/06 edition are not acceptable.

Where to File :

The Immigration Officer assisting you with this form will submit it to:

Data Unit, Office of Refugee Resettlement
Department of Health and Human Services
370 L'Enfant Promenade S.W. (6th Floor)
Washington, DC 20447

Filing Fee :

$0.00

Special Instructions :

(NA)

• Download I-643 (168KB PDF)

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USCIS Forms information is provided as a service, but we cannot guarantee the accuracy of the information. Please refer to the USCIS website or speak directly with a lawyer before making decisions.