Form Ds-234 - Special Immigrant Visa Biodata Form Page 2

Download a blank fillable Form Ds-234 - Special Immigrant Visa Biodata Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Ds-234 - Special Immigrant Visa Biodata Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Date of Birth

Family Member Name

(dd mmm yyyy)

Special Immigrant Visa

If unknown,

Case Number

check box

Last

First

Middle

Relationship to you

(Select)

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.

Yes

Date of Birth

(dd mmm yyyy)

Relationship to you

Address

Phone Number

E-mail Address

Name

If unknown,

check box

Last

First

Middle

(Select)

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. If you have comments on the

accuracy of this burden estimate and/or recommendations for reducing it, please send them to: DOS/PRM, Office of Admissions, 2025 E Street, NW

Washington, DC 20522-0908.

DS-234

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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.gov .