I-643, Health and Human Services Statistical Data for Refugee/Asylee Adjusting Status
Purpose of Form :
Number of Pages :
Edition Date :
10/29/09. Previous editions accepted.
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 :
Special Instructions :
Note on Expiration: USCIS continues to accept the 10/29/09 version of Form I-643, despite the passing of the form’s expiration date. An updated form with a new expiration date will be posted as soon as it becomes available.