Refugee Benefits Election Form PDF Details

Are you a refugee, or the sponsor of a refugee? Understanding how to manage your benefits and resources is an important step in establishing yourself. The federal government provides services for refugees from abroad such as employment authorization through 8 USC § 1101(a)(27) and benefits related to health coverage under ISDH Section 5b2. For those wishing to apply for these types of assistance, having access to a Refugee Benefits Election Form (RB-F3) can be essential. This blog post will provide information about the purpose, eligibility requirements, and rules surrounding this particular form – so read on if you’re looking for more details!

QuestionAnswer
Form NameRefugee Benefits Election Form
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesresettlement form refugee, you biodata issued download, ds biodata download, stated ds biodata form

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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 30-90 days in the United States. Please see below for information regarding benefits funded by the Health and Human Services Office of Refugee Resettlement (ORR) for which you may qualify.

You must indicate your decision to receive or decline Department of State resettlement benefits by returning the attached Refugee Benefits Election Form and the DS-0234 Special Immigrant Visa Biodata Form to the National Visa Center (NVC), the Refugee Processing Center (RPC), or the appropriate Resettlement Support Center (RSC) as soon as possible but no later than 10 calendar days after your visa issuance date, as printed on your visa. These forms will allow us to initiate processing of your case. In addition, you must submit a scanned copy of your visa foil as soon as possible but not later than 30 calendar days prior to your visa’s expiration. We cannot book your travel until we receive a copy of your visa. You should not wait to submit the Refugee Benefits Election Form and the DS-0234 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 State-funded resettlement benefits.

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 Department-funded RSC based in Amman, Jordan. If you are an Iraqi applicant and your visa is being processed by the U.S. Embassy in Ankara or Beirut, your application for benefits will be processed by the RSC based in Istanbul, Turkey. If your visa is being processed by a U.S. Embassy in any other location, your application for benefits will be handled by the RPC. All Afghan applicants will be processed for benefits by the RPC, regardless of embassy location.

Resettlement is a multi-step process. If you choose to participate in the program, the U.S. Department of State will need to make important arrangements in advance of your departure. Because your visa is valid for only a limited time (usually 90 days), it is important that you submit all required paperwork (including a scanned copy of your visa) before the deadlines indicated above, and that you respond to requests for additional information as promptly as possible.

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, US-based family and friends, and medical issues. The resettlement agency will use this information to determine the resettlement site that is best suited for you and your family, and to prepare for your arrival. If you have family members or friends in the United States that you would like to be resettled near, you should indicate this on page 2 of the DS-0234 Biodata Form. While you can express a view about where you might be resettled, if you elect to participate in this program, we cannot guarantee that you will be given your preference.

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 IOM-arranged flight. You may pay for your travel either with an interest-free loan, or pre-pay the cost of your ticket. If you choose the loan, you will be required to sign a promissory note committing to repay the loan over a three-year period. Upon arrival to the United States, IOM representatives will assist you at the port of entry and help you with immigration and customs procedures. When you reach your final destination, a representative from the resettlement agency to which you are assigned will meet you at the airport, take you to your initial housing, and assist you in settling you into your new community.

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 DS-0234 Biodata Form to the NVC, RPC, and/or RSC as soon as possible but no later than 10 calendar days after your visa issuance date, as indicated on your visa. In addition, we must receive a scanned copy of your SIV as soon as possible but not later than 30 calendar days prior to visa expiration. The Department of State will not be able to accommodate requests for benefits submitted after these deadlines. As stated above, you should not wait to submit the Refugee Benefits Election Form and the DS-0234 Biodata Form until your visa is issued. All three items must be received by the NVC, RPC, or RSC by the deadlines indicated above.

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: http://www.wrapsnet.org/SIVIraqiP2/tabid/290/language/en-US/Default.aspx

These State Department-funded benefits are separate from benefits funded by the Health and Human Services Office of Refugee Resettlement (ORR). Therefore, if you choose to decline State Department-funded benefits, you may still be eligible for ORR-funded benefits upon your arrival to the United States. ORR-funded benefits provide a variety of services and have strict time limits and guidelines for participation. You can find additional information about these benefits by visiting the ORR website here: http://www.acf.hhs.gov/programs/orr

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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 IOM-arranged travel. If there are any changes in my intention to participate, or if my family composition changes (e.g. a birth or death), I will notify the Refugee Processing Center and/or Resettlement Support Center as soon as possible.

_____ 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 Department-funded benefits, I understand that I may still qualify for certain ORR- funded benefits.

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), professional-level employment, and medical insurance are not guaranteed. I also understand that housing assistance funding is not guaranteed by the U.S. State Department beyond my first 30 days in the United States.

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 DS-0234 Special Immigrant Visa Biodata Form to the National Visa Center (NVCSIV@state.gov), Refugee Processing Center (siv@wrapsnet.org), or appropriate Resettlement Support Center as soon as possible but no later than 10 calendar days after your visa issuance date. In addition, you must submit a scanned copy of your visa as soon as possible but not later than 30 calendar days prior to expiration.

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 State-funded refugee benefits.

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