I-602 Pas

USCIS Privacy Act Statement
Form I-602

AUTHORITIES: The information requested on this form, and the associated evidence, is
collected pursuant to Sections 207 and 209 of the Immigration and Nationality Act, as amended,
as well as 8 CFR 207.3.
PURPOSE: The primary purpose for providing the requested information on this form is for a
refugee who has been found inadmissible to the United States for reasons such as a criminal
conviction or certain health conditions to apply for a waiver of such inadmissibility on grounds
of humanitarian reasons, family unity or national interest. The information you provide will be
used to grant or deny the waiver.
DISCLOSURE: The information you provide is voluntary. However, failure to provide the
requested information and any requested evidence may delay a final decision or may result in
denial of the waiver.
ROUTINE USES: The information you provide on this benefit application may be shared with
other federal, state, local, and foreign government agencies and authorized organizations in
accordance with approved routine uses, as described in the associated published system of
records notices [DHS-USCIS-007 - Benefits Information System and DHS-USCIS-001 - Alien
File, Index, and National File Tracking System of Records, which can be found at
www.dhs.gov/privacy]. The information may also be made available, as appropriate for law
enforcement purposes or in the interest of national security.

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