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
Form 1; Instructions 2.
01/08/13. Previous editions accepted.
Where to File
The Immigration Officer assisting you with this form will submit it to:
Data Unit, Office of Refugee Resettlement
This page can be found at http://www.uscis.gov/i-643
Last Reviewed/Updated: 04/10/2013