For individuals embarking on the challenging journey of resettling in the United States under a Special Immigrant Visa (SIV), navigating the early days of their new life involves understanding and managing various bureaucratic processes, one of which includes the Refugee Benefits Election Form. This critical document, issued by the United States Department of State, serves as a key that can unlock essential resettlement benefits designed to assist refugees in the initial stage—ranging from 30 to 90 days—of their resettlement. It outlines an option to receive U.S. Department of State’s resettlement program benefits, which are distinct from those funded by the Health and Human Services Office of Refugee Resettlement (ORR), thus allowing for a broader spectrum of support. Applicants are urged to make a well-informed decision, relying on accompanying materials such as Frequently Asked Questions and a guide on what to expect when resettling in the United States. The form must be submitted promptly—no later than 10 days after visa issuance along with the DS-0234 Special Immigrant Visa Biodata Form—to initiate the processing of the case and ensure travel arrangements can be made in time. The program underscores the importance of adherence to deadlines and accurate information provision, as these elements critically influence the resettlement agency's ability to assist effectively. Furthermore, the program's design reflects a structured approach to assist refugees in acclimatizing to life in the U.S., including financial support, housing for the first 30 days, employment services, and more, thus laying a foundation for a successful transition.
| Question | Answer |
|---|---|
| Form Name | Refugee Benefits Election Form |
| Form Length | 6 pages |
| Fillable? | Yes |
| Fillable fields | 8 |
| Avg. time to fill out | 3 min 10 sec |
| Other names | ds biodata sample, resettlement form refugee, resettlement form, ds 0234 form |
United States Department of State
Washington, D.C. 20520
Dear Applicant:
Our records indicate that you have applied for a Special Immigrant Visa (SIV). If you are issued such a visa, you have the option to receive certain benefits under the U.S. Department of State’s resettlement program that are available to refugees who are resettling in the United States. Please read the contents of this letter carefully, including the accompanying Frequently Asked Questions and 17 Things You Need to Know about Resettling in the United States. These documents will help you make an informed decision about electing to receive (or decline) resettlement benefits through our program, which covers only your first
You must indicate your decision to receive or decline Department of State resettlement benefits by returning the attached Refugee Benefits Election Form and the
of
As of July 2010, the entity responsible for processing your Department of State benefits will depend on the location of your visa issuance post. If you are an Iraqi applicant and your visa is being processed by the U.S. Embassy in Baghdad, Amman, Cairo, or Damascus, your application for resettlement benefits will be processed by the
Resettlement is a
The information you provide to the NVC/RPC/RSC will be shared with a U.S. resettlement agency, which will provide you with basic services intended to help you adjust to life in the United States. Please read the accompanying Frequently Asked Questions and 17 Things You Need to Know about Resettling in the United States to better understand what these basic services do and do not include. The agency’s ability to successfully assist you with your resettlement in the U.S. depends on the accuracy and timeliness of the information you provide, including information about your education, occupation, ethnicity, religion,
Once your case has been assigned to a resettlement agency and your visa has been issued, the International Organization for Migration (IOM) will contact you to arrange your travel. To the extent possible, IOM will work with you to determine a travel date that is convenient for you. Please note that if you choose to participate in this resettlement benefits program, you may not make travel arrangements on your own. You must travel on an
The U. S. Government has established guidelines and provides funding for the resettlement services that you will receive upon arrival in the United States. Your resettlement agency will have a local office in or near the town where you will be resettled and will provide basic living assistance and support for the first 30 days after you arrive. The following are some of the things you should expect to do and/or receive during your first weeks in the United States:
The resettlement agency to which you are assigned receives $1,875 per person in U.S. Government funds, of which a minimum of $925 must be spent directly on your behalf. These funds will be used to pay for your rent and/or basic necessities. Some portion of it may be given directly to you in cash. The resettlement agency will make sure you have a small amount of money for daily needs.
Housing for your first 30 days.
Apply for a social security card, required for work.
Learn about and be assisted with access to employment services (while the agency will assist in whatever way it can, it is ultimately your responsibility to find and maintain employment).
Assist with enrolling your children in school.
Learn to use public transportation (a car will not be provided).
Assist you with access to English language classes, if necessary.
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Begin to learn about U.S customs and law.
Learn about and be assisted with access to community services that can help you, including social services, cash and medical assistance, and food stamps, if necessary.
Find out about other government services and programs and how to access services.
If you choose to participate in this resettlement benefits program, it is essential that you submit the attached Refugee Benefits Election Form and the
Additional information regarding the U.S. Department of State resettlement program can be found on the RPC website. Arabic, Dari, and Pashtu translations of this letter, as well as the Frequently Asked Questions (FAQs) and 17 Things You Need to Know about Resettling in the United States are also available on the website here:
These State
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Refugee Benefits Election Form
PLEASE INDICATE YOUR ELECTION BELOW:
If approved to receive a Special Immigrant Visa,
_____ I wish to participate in the U.S. Department of State’s resettlement program and receive
the associated benefits including
_____ I have read this information letter and DO NOT wish to participate in the U.S.
Department of State’s resettlement program. I understand that I will be unable to reverse my decision beyond ten days after the date on which my SIV is issued. Even though I choose to decline State
By signing this form, I acknowledge that I have read the U.S. State Department letter and the accompanying Frequently Asked Questions and 17 Things You Need to Know about Resettling in the United States. I understand that resettlement benefits vary from one location to another, and that luxury items (including TVs, radios, telephones, DVD players, computers, vacuums, bicycles, cars, or air conditioners),
Petitioner’s Case Number: ______________________________
_____________________________________ |
__________________________________ |
Name (block letters, in English only) |
Date of Birth (MM/DD/YYYY) |
______________________________________ |
__________________________________ |
Email Address |
Telephone Number |
______________________________________ |
__________________________________ |
Signature |
Date (MM/DD/YYYY) |
Please return a scanned copy of this page only and the
You should not wait to submit this form and the Special Immigrant Biodata Form until your visa is issued. All three items must be received by the NVC, RPC, or RSC prior to the deadlines indicated above. Failure to do so will result in the denial of any future request for
Department of
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