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INSTRUCTIONS - DS-7699, AFFIDAVIT OF RELATIONSHIP (AOR) FOR MINORS WHO ARE
NATIONALS OF EL SALVADOR, GUATEMALA, OR HONDURAS
NOTE: Read these instructions carefully. If you do not follow the instructions, the U.S. Department of State, or its designated representative, may
return your Affidavit of Relationship (AOR) for clarification or correction. By completing this form you are claiming a relationship with a child/children
abroad in order to assist the U.S. Government in determining whether that child/those children should be granted access to the U.S. Refugee
Admissions Program (USRAP). The AOR itself is not an application on behalf of your child(ren) for admission to the United States as a refugee under
the USRAP or a petition for any immigration benefit under U.S. law. Completion of this AOR does not guarantee that your child(ren) will be found
qualified to apply for refugee admission or that they ultimately will be admitted to the United States. Additionally, the information on this form may also
be used by the U.S. Government to verify information provided by these individuals in relation to any immigration benefit they may subsequently seek
under U.S. law and other uses as described in the Privacy Act Statement on the AOR and in Part 10 of these instructions below. The U.S. Government
investigates claimed family relationships and verifies the validity of documents. Criminal prosecutions may be sought when family relationships are
falsified to obtain immigration benefits.
1. Purpose of This Form
The AOR provides a means for certain persons in the United States to claim a relationship with a child(ren) in El Salvador, Guatemala, or Honduras
and to assist the U.S. Department of State in determining whether that child/those children should be granted access to the USRAP for family
reunification purposes. Resettlement agency representatives, who assist persons with this form, are knowledgeable about who may file this form. This
form also assists the U.S. Department of Homeland Security's U.S. Citizenship and Immigration Services (USCIS) to verify parent-child relationships
during refugee case adjudication. The main purpose of the AOR is for you (the Qualifying Parent) to provide biographical information about children
living outside the United States who may subsequently seek access to the USRAP for verification by the U.S. Government.
2. Who May File This Affidavit?
You may file the AOR if you are at least 18 years of age and are in the United States in one of the following categories:
a. Lawful Permanent Resident Status
b. Temporary Protected Status Grantee
c. Parolee who has been issued parole for a minimum of one year
d. Deferred Action Recipient granted deferred action for a minimum of one year, including Deferred Action for Childhood Arrivals (DACA) recipients
e. Deferred Enforced Departure Recipient
f. Withholding of Removal Grantee
3. Who Is Qualified to Apply for Refugee Admission Based on this AOR?
Type A: Your unmarried child(ren) under 21 years of age (when the AOR is filed with the Refugee Processing Center (RPC) who continue to be
unmarried at the time of admission or parole to the United States at the port of entry) and who are nationals of El Salvador, Guatemala, or Honduras
may be qualified to apply for admission to the United States as a refugee under the USRAP. Please list them in Section II, Part A of the AOR as the
Qualifying Child.
Type B: Unmarried child(ren) under 21 years of age of the Qualifying Child may be included on the Qualifying Child's refugee application and may be
qualified to apply for admission to the United States as derivative beneficiaries with the Qualifying Child as a refugee if otherwise admissible to the
United States. These individuals would derive their refugee status from the Qualifying Child and do not have to independently establish that they
qualify as a refugee. Please list them in Section II of the AOR as Type B relatives. If the Qualifying Child is approved for parole, his/her unmarried
child(ren) under 21 years of age would also be considered for parole.
Type C: On a case-by-case basis, the legal parent of a Qualifying Child may also be considered qualified to apply for admission as a refugee in
connection with a Qualifying Child if that individual:
1. lives in the same household as the Qualifying Child;
AND,
2. is part of the same economic unit as the Qualifying Child;
AND,
3. maintains a documented marriage to you (the Qualifying Parent), the filer of this form.
Please list him/her in Section II of the AOR as a Type C relative.
A legal parent cannot derive his/her refugee status from the Qualifying Child and therefore must independently establish that he/she qualifies as a
refugee. If the legal parent has an unmarried child(ren) under 21 who is not your child, you may also add him/her in Section II as a Type C-3 relative.
The Type C-3 relative would derive his/her refugee status from the Type C relative and does not have to independently establish that he/she qualifies
as a refugee. If the Type C relative is approved for parole, the Type C-3 relative would also be considered for parole.
Type D: On a case-by-case basis, the biological parent of a Qualifying Child that is not legally married to you (the Qualifying Parent) may also be
considered qualified to apply for admission in connection with a Qualifying Child if that individual:
1. lives in the same household as the Qualifying Child;
AND,
2. is part of the same economic unit as the Qualifying Child.
Please list him/her in Section II of the AOR as Type D relatives.
A biological parent cannot derive his/her refugee status from the Qualifying Child and therefore must independently establish that he/she qualifies as a
refugee. If the biological parent has a legal spouse that is not you (the Qualifying Parent) or an unmarried child(ren) under 21 who is not your
child, you may also add them in Section II as a Type D-2 (for spouse) or Type D-3 (for child) relative. The Type D-2 and/or Type D-3 relative
would derive his/her status from the Type D relative and does not have to independently establish that he/she qualifies as a refugee. If the Type D
relative is approved for parole, the Type D-2 and/or Type D-3 relative would also be considered for parole.
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09-2016
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Type E: On a case-by-case basis, the primary caregiver of a Qualifying Child that does not qualify for Type C (legal parent married to Qualifying
Parent) or Type D (biological parent not married to Qualifying Parent) may also be considered qualified to apply for admission in connection with a
Qualifying Child if that individual:
1. lives in the same household as the Qualifying Child;
AND,
2. is part of the same economic unit as the Qualifying Child;
AND,
3. is the Qualifying Child's primary caregiver;
AND,
4. is at least 18 years of age;
AND,
5. is related to you (the Qualifying Parent) biologically or by legal marriage;
OR;
6. is related to the Qualifying Child via a biological, step, or adoptive relationship.
Please list him/her in Section II of the AOR as a Type E relative.
A caregiver cannot derive his/her refugee status from the Qualifying Child and therefore must independently establish that he/she qualifies as a
refugee. If the caregiver has a legal spouse or an unmarried child(ren) under 21, you may also add them in Section II as a Type E-2 (for spouse) or
Type E-3 (for child) relative. The Type E-2 and/or Type E-3 relative would derive his/her status from the Type E relative and does not have to
independently establish that he/she qualifies as a refugee. If the Type E relative is approved for parole, the Type E-2 and/or Type E-3 relative would
also be considered for parole.
Note:
- Only one Type E relative and his/her derivative(s) may be listed on the form unless the Qualifying Children listed on the form live in different
households. Each Qualifying Child that lives in a separate household from another listed Qualifying Child would be allowed to list one separate primary
caregiver.
- If your married and/or age 21 or older son or daughter is the primary caregiver of the Qualifying Child, he/she can be listed as a Type E relative if
there is no other qualifying caregiver. See below under Type F for additional information.
Type F: On a case-by-case basis, if you (the Qualifying Parent) have married son(s) or daughter(s) and/or son(s) or daughter(s) over 21 years of age,
they may also be considered qualified to apply for admission in connection with a Qualifying Child.
Please list them in Section II of the AOR as Type F relatives.
Married son(s) or daughter(s) and/or son(s) or daughter(s) over 21 years of age cannot derive their refugee status from the Qualifying Child and
therefore must independently establish that they qualify as a refugee. If the married son(s) or daughter(s) and/or son(s) or daughter(s) over 21
years of age have a legal spouse and/or an unmarried child(ren) under 21 you may also add them in Section II as a Type F-2 (for spouse) or Type
F-3 (for child) relative. A Type F-2 and/or F-3 relative would derive his/her refugee status from the Type F applicant and does not have to
independently establish that he/she qualifies as a refugee.
Note: A married son or daughter and/or son or daughter over 21 years of age may instead be listed on the form as a Type E relative if he/she is the
primary caregiver of the Qualifying Child and meets the other criteria for a Type E relative. This would preclude another caregiver from being listed as
a Type E relative on the form for that Qualifying Child.
Please note:
- Type B to F relatives and any of their derivatives (as described above) must be interviewed by USCIS with the Qualifying Child. If the Qualifying
Child and a type B to F relative(s) are unable to be interviewed together, only the Qualifying Child would receive a USCIS refugee interview.
- Legal Parent: In order to be claimed on this AOR as a legal parent of the Qualifying Child in Section II, the marriage between you and this other
parent of the Qualifying Child must have existed on the date you completed this form and must continue at the time of admission to the United States.
- Adopted Child: In order to be claimed on this AOR as a Qualifying Child or as a derivative in Section II, an adopted child must have been in the legal
custody of and resided with the adopting parent or parents for at least two years and been legally adopted before his/her 16th birthday.
- Stepchildren: In order to be claimed on this AOR as a Qualifying Child or as a derivative in Section II, the marriage creating the step relationship must
have occurred before the child's 18th birthday.
- In all cases, in order for your children to be considered Qualifying Children, they must be unmarried and under 21 years of age when the AOR is filed
with the RPC and continue to be unmarried at the time of admission to the United States at the port of entry.
4. Where Do You File This Form?
The AOR is prepared by you with assistance from a local resettlement agency participating in the Department of State's Refugee Reception and
Placement Program, and submitted to the U.S. Department of State by the agency's national headquarters office. AORs submitted directly to
Resettlement Support Centers (RSCs) or by you to the U.S. Government will NOT be accepted.
5. What Additional Information Must Be Provided With the AOR?
You must attach a copy of the applicable document that provides proof of your eligibility. AORs submitted without such document(s) will NOT be
accepted.
Acceptable Proof of Eligibility:
a. Lawful Permanent Resident (LPR): Legible copy of both sides of Permanent Resident Card or any temporary proof of permanent residence
status issued by the U.S. Citizenship and Immigration Services (USCIS); copy of a 551 stamp in a passport; or legible copy of an Executive Office for
Immigration Review (EOIR) order or a final order issued by an immigration judge or the Board of Immigration Appeals granting lawful permanent
residence.
b. Temporary Protected Status (TPS): I -797 Approval Notice for Form I-821; Employment Authorization Document (EAD) based on category
(a)(12) or (c)(19) Temporary Protected Status; an EOIR order or a final order issued by an immigration judge or the Board of Immigration Appeals
granting TPS; or an I-94 Arrival Departure Record noting TPS.
c. Parole: Copy of I-94 Arrival/Departure Record noting that parole has been authorized for at least one year; or an EAD based on category (a)(4) or
(c)(11).
d. Deferred Action (DACA): I-797 Approval Notice for Form I-821D Consideration for Deferred Action for Childhood Arrivals; or an EAD with
category (c)(33) Deferred Action for Childhood Arrivals. Deferred Action (non-DACA): Order, notice or document (from ICE or USCIS) reflecting the
exercise of deferred action (such as an I-797); or an EAD based on category (c)(14) Deferred Action. Persons granted deferred action must have been
issued deferred action for a minimum of one year.
e. Deferred Enforced Departure: EAD based on category (a)(11) Deferred Enforced Departure or other evidence that they were covered by the
Executive Order establishing DED. NOTE: Currently only Liberia is covered by DED.
f. Withholding of Removal: Copy of the EOIR order granting Withholding of Removal; or a final order issued by an immigration judge or the Board of
Immigration Appeals.
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Affidavit of Support:
You (the Qualifying Parent) must provide Form I-134 Affidavit of Support (AOS) for a Type D or Type E relative listed on the AOR. Provide one Form
I-134 AOS for each Type D and Type E relative family unit. For purposes of Form I-134 AOS, a relative family unit consists of a Type D (the
biological parent of the qualifying child not married to you) or Type E (the primary caregiver) reative and his or her accompanying spouse Type D2/E2
(spouse) and Type D3/E3 (children). This Affidavit of Support will be kept on file and be used if individuals are considered for parole and will
not be used for cases granted refugee status. For additional information please see U.S. Citizenship and Immigration Services website "I-134,
Affidavit of Support" at: https://www.uscis.gov/i-134
Additional Documents:
If you are filing for an adopted child, please provide a copy of the adoption papers. If you are filing for a stepchild, please provide a copy of your
marriage certificate to that child's parent. Please provide these documents for any derivatives of Type A, B, C, D, E, or F relatives claimed on the basis
of an adopted or step relationship.
Please provide birth certificates for all beneficiaries listed on the AOR.
For any current or previous marriages of the Qualifying Parent, Caregiver, or sons and daughters, please provide a copy of the marriage certificates
and/or divorce documents.
For any Type E relatives (primary caregivers) please provide any documents that may show membership in the same household and economic unit
and the caregiver role to the Qualifying Child. This may include but is not limited to documents that show a shared address between the Qualifying
Child and caregiver and school or medical records that note the Type E relative's caregiver role to the Qualifying Child.
For Type E and F relatives, provide a statement in Section II, Comments noting the relationship between the relatives and the Qualifying Child.
Specifically for Type E, describe how the primary caregiver is related to you (the Qualifying Parent) or the Qualifying Child. Please provide a statement
noting who has legal custody of the Qualifying Child. If legal custody of the Qualifying Child is not with a parent, please provide documents that
establish that legal custody resides with another individual. Provide an explanation in Section II.
NOTE: If you (the Qualifying Parent) are unable to provide any of the documents above please provide an explanation in Section II.
6. What Additional Information May Need to be Provided to Establish a Family Relationship?
If you claimed a biological relationship, you and your biological child(ren) listed in Section II of the AOR will be required to provide a DNA sample at a
later date to establish your biological relationship. A DNA sample will also be required from a biological parent of a Qualifying Child that is not legally
married to you (the Qualifying Parent) if he/she is listed in Section II of the AOR. A DNA sample will also be required between you (the Qualifying
Parent) and the married and/or age 21 or older son(s) or daughter(s) if they are listed on the AOR. A DNA sample will also be required between you
(the Qualifying Parent) and caregiver if the biological relationship can be verified through DNA testing (ie. biological grandparent). You will receive a
notice providing full instructions on how to arrange for DNA relationship testing by the Resettlement Support Center. By signing your name on the
AOR, you are agreeing to provide the DNA sample when requested by an official of the U.S. Government, or its designated representatives. Please
note that if you or your claimed family members fail to submit DNA evidence upon request, your family members' access to the USRAP may be
terminated. An officer of USCIS will make the final determination regarding whether a bona fide relationship exists between you and your relative(s) at
the time of the interview for refugee status.
7. Who will Pay the Costs of DNA Testing?
You must pay all costs associated with DNA testing of both you and your biological Qualifying Child(ren); biological parent of the Qualifying Child(ren);
married and/or 21 or older son(s) or daughter(s); and caregiver (when applicable), if you claimed a biological relationship. In addition, you will be
expected to pay the costs of any additional testing requested and described on the AOR. The U.S. Government will reimburse the cost of DNA testing
if such tests confirm all claimed biological relationships, provided you fall into one of the categories listed in paragraph 2, above (Who May File This
Affidavit?).
8. What Are the General Instructions for Completing the AOR?
The AOR must be completed in English: The Resettlement Agency, with whom the Department of State maintains Cooperative Agreements on
refugee resettlement, is instructed to complete this form electronically. Handwritten applications will not be processed and will be returned to you. If you
need extra space to complete any item, attach a separate continuation sheet. Indicate the item number, and date and sign each sheet.
Each section of the AOR must be fully completed: If you do not know the answer to a question, please write "Unknown". If questions asked do not
apply to you, please state "N/A", meaning "Not Applicable". You are responsible for providing detailed information to the best of your knowledge. If you
do not have all the information required BUT you can obtain the information needed, please wait to submit the AOR until all of the information is
received. If there is insufficient space in any section, please continue in Section IV or use supplemental sheets.
Contact information: The address of your child(ren) abroad must be as complete as possible - at a minimum, a phone number is required. Provide
contact information for the child's guardian and other parent (if not the guardian). If the child's guardian is not their parent, please provide an
explanation in the Comments of Section II.
Photograph: Please upload a passport style photograph for each relative listed in Section II. Frame the photograph as a front view of the applicant's
full face, from the top of the head to the shoulders with eyes open. Upload the photo in .bmp or .tif format.
Names: Use a complete name each time a name is requested. Do not use initials. If applicable, please include the patronymic (a name derived from
the father or a paternal ancestor), in Section IV. If the middle name of the person has only one letter, or if there is any different naming structure, this
should be clarified in Section IV. If anyone uses an alias, provide that information in Section IV or on a supplemental sheet.
Ages and dates: Always give exact dates of birth and of significant events, like marriage, if they are known. If unknown, please provide the
best-estimated date and check the appropriate box. For all persons, where the Date of Birth is not known, please provide an estimate and check the
box; if the City/Country of Birth is not known, please provide the best guess and then explain in Section IV. All dates must comply with the following
format: DD MMM YYYY (example, "14 FEB 1965").
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Relatives: Be sure to include in Section III the following relatives not otherwise listed on the AOR form who live in the United States or abroad, whether
living, deceased or missing: Spouses (Current and Former) and Children (Biological/Adopted/Step/Foster). Use Section IV to explain any
non-biological relationships, including adoptive or foster relationships. If a family member is deceased or the present location of the family member is
unknown, please indicate this, and give the date of death or last contact in the "Current or Last Known City/Country" column. Please use the
relationship codes provided at the end of this document to indicate relationships between persons, as requested on this form.
No agency representative or other USRAP processing partner may solicit or accept money or any other favor in order to prepare, file, or
process the AOR (also known as the DS-7699).
9. What Are the Penalties for Committing Fraud?
Title 8, United States Code, Section 1325(a)(3), states that any person who attempts to enter or obtains entry to the United States by a willfully false or
misleading representation or the willful concealment of a material fact shall be imprisoned for not more than five years, or fined not more than
$250,000, or both.
Title 18, United States Code, Section 1001, states that whoever willfully and knowingly falsifies a material fact, makes a false statement or makes use
of a false document will be fined up to $10,000 or imprisoned up to five years, or both.
If it is determined that a genuine relationship does not exist between you and the person(s) you are claiming as your child(ren), then their access to the
USRAP, and that of their family members, may be terminated.
Misrepresenting your relationship to an individual(s) so that such individual(s) may gain access to the refugee program could make you inadmissible to
the United States, make you ineligible for certain immigration benefits, and/or render you subject to removal.
10. What Is Our Authority for Collecting This Information and How May We Use It?
The U.S. Department of State requests the information on this form, including the agreement of the Qualifying Parent to provide a DNA sample at a
later date, to carry out the immigration laws contained in Title 8, United States Code, Section 1157. The U.S. Department of State requests this
information to assist in determining whether a family member (including biological relatives) claimed on this form is qualified for access to the U.S.
Refugee Admissions Program (USRAP) for the purposes of family reunification. The information you provide may also be disclosed to a) the U.S.
Department of Homeland Security for purposes of determining whether your relatives are eligible for admission or parole to the United States and for
verifying information provided by the family members listed on this form in any application they may make for admission to the United States under the
USRAP or for any other immigration benefit under U.S. law; b) Members of Congress or other Federal, State, and local government agencies having
statutory or other lawful authority, as needed for the formulation, amendment, administration, or enforcement of immigration, nationality, and other laws
of the United States; and, c) international organizations and resettlement agency partners that work with the USRAP to enable them to coordinate and
manage refugee processing overseas and resettlement in the United States. You do not have to complete this form and provide the requested
information; however, if you refuse to give some or all of the requested information, your relatives' access to the USRAP for refugee resettlement
consideration may be denied.
Paperwork Reduction Act
An agency may not conduct or sponsor an information collection and a person is not required to respond to a collection of information unless it displays
a currently valid OMB control number. The public reporting burden for this collection of information is estimated to average 120 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: U.S. Department of State, PRM/A, 2025 E Street, NW Washington DC, 20520. OMB No. 1405-0206.
HOW TO FILL OUT THIS FORM
SECTION I: INFORMATION ABOUT YOU, THE QUALIFYING PARENT
This section is for information about you. You must be at least 18 years of age to file an AOR.
a. Enter your full name.
b. Enter your date of birth: dd mmm yyyy (day, month, year; 14 FEB 1965).
c. Enter your sex: M or F.
d. Enter your marital status: single (S), married (M), divorced (D), separated (P), widow/widower (W).
e. Enter the name of your current spouse.
f.
Enter your city and country of birth.
g. Provide your current U.S. address.
h. Enter your home telephone number, work telephone number, and cellular phone number.
i.
Enter your e-mail address.
j.
Enter your date of arrival in the United States: dd mmm yyyy (day, month, year; 14 FEB 1965).
k. Indicate your current status in the U.S. using the drop down box.
l.
Provide the date your current status was granted: dd mmm yyyy (day, month, year; 14 FEB 1965).
m. Your nationality.
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SECTION II: INFORMATION ABOUT QUALIFYING FAMILY MEMBERS SEEKING ACCESS TO THE USRAP
This section is for the Qualifying Child(ren) you are claiming a relationship with to support their access to the USRAP so they may apply for admission
to the United States as a refugee. This section is also for Type B, C, D, E, and F relatives. Other relatives should be listed in Section III.
Please use a separate page for each Qualifying Child you are claiming. List any unmarried children of the Qualifying Child and any members of his or
her household/economic unit on that page. You may use as many pages as necessary to include each Qualifying Child you are claiming. Please use
the List of Relationship Codes to indicate the requested relationships in the "Relationship to Child" and "Relationship to Qualifying Child Listed Above"
columns.
Line 1: Please provide the requested information only for an unmarried child under age 21. If the Date of Birth is not known, please estimate and check
the box; if the City/Country of Birth is not known, please provide the best guess and then explain in Section IV. If the answer to other questions is not
known, please write "unknown." If a question is not applicable, please write N/A.
Please provide the contact information for the person listed on Line 1 where requested and contact information for a guardian. If the guardian is not the
other parent, provide other parent's contact information in the space provided.
Lines 2-10: Please list from oldest to youngest, unmarried children under age 21 of the Qualifying Child named on line 1 who wish to be considered for
resettlement at this time. Please enter "B" in the box under "Type" to specify that this person is a derivative of the Qualifying Child. If applicable, please
also include the parent of the Qualifying Child named on Line 1 (Type C), and his/her biological or legally adopted child who is not also the child of the
Qualifying Parent and who meet the requirements listed in the instructions under number 3 on page 1. For these individuals, enter "C" in the box under
"Type." If applicable, please also include the Type D, E, or F relative, and his/her legal spouse and biological, step, or legally adopted child who is not
also the child of the Qualifying Parent and who meet the requirements listed in the instructions under number 3 on page 1. If the Date of Birth is not
known, please estimate and check the box; if the City/County of Birth is not known, please provide the best guess and then explain in Section IV.
SECTION III: INFORMATION ABOUT ALL OF YOUR RELATIVES NOT PREVIOUSLY PROVIDED IN SECTION II
This section is for all of your relatives (spouses and children) in the United States or abroad, whether living, deceased or missing, that were NOT
previously listed in Section II. Please remember that these relatives are not being considered for access to the USRAP.
Please use the List of Relationship Codes to indicate the requested relationships in the "Relationship to Qualifying Parent" columns.
(A) Please provide information about your spouse and all previous spouses that was NOT previously provided in Section II.
(B) Please provide information about all your children (including biological, adopted, step and foster children) from oldest to youngest that was NOT
previously provided in Section II.
SECTION IV: ADDITIONS/EXPLANATIONS
Please use this section to elaborate on any extended or non-traditional relationships that may require further explanation (including adopted, half, and
step relatives), any unusual name patterns, any aliases, or any unusual circumstances that you wish to address. Please also use this section as a
continuation page for any other sections that had insufficient space.
SECTION V: SIGNATURES
Please read the certification and then sign your name, print your name, and fill in the date. You will be asked to provide valid identification to the
resettlement agency representative who assisted you to fill out this form. The resettlement agency representative will then sign the form, print his/her
name, date the form, and provide the affiliate name, address and telephone number.
By submitting this Affidavit of Relationship you understand that you and your biological Qualifying Child(ren); biological parent of Qualifying Child(ren);
married and/or older son(s) and daughter(s); and caregiver (when applicable) may be required to submit DNA evidence. You further understand that
DNA testing could be requested between your biological Qualifying Child(ren) and his/her family member(s) and their derivative beneficiaries in order
to establish a familial relationship. You also understand that access to the USRAP for your family members may be terminated if insufficient evidence
exists to establish the familial relationship claimed on this form.
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LIST OF RELATIONSHIP CODES
CODE
RELATIONSHIP
CODE
RELATIONSHIP
AB
ADOPTIVE BROTHER
GN
GREAT GRANDSON
AD
ADOPTED DAUGHTER
GU
GUARDIAN
AF
ADOPTIVE FATHER
HB
HALF BROTHER
AM
ADOPTIVE MOTHER
HS
HALF SISTER
AR
ADOPTIVE SISTER
HU
HUSBAND
AS
ADOPTED SON
MC
COUSIN (MALE)
AU
AUNT
MR
RELATIVE BY MARRIAGE
BH
HUSBAND'S BROTHER
MW
MINOR WIFE
BR
BROTHER (BIOLOGICAL)
MO
MOTHER (BIOLOGICAL)
DA
DAUGHTER (BIOLOGICAL)
MI
MOTHER-IN-LAW
DI
DAUGHTER-IN-LAW
NE
NEPHEW
DR
DISTANT RELATIVE
NI
NIECE
EH
EX-HUSBAND
NF
UNION WITH FEMALE
EW
EX-WIFE
NM
UNION WITH MALE
FA
FATHER (BIOLOGICAL)
SI
SISTER (BIOLOGICAL)
FI
FATHER-IN-LAW
SO
SON (BIOLOGICAL)
FC
COUSIN (FEMALE)
SL
SON-IN-LAW
FN
FIANCE(E)
SB
STEP BROTHER
FB
FOSTER BROTHER
SD
STEP DAUGHTER
FD
FOSTER DAUGHTER
SF
STEP FATHER
FF
FOSTER FATHER
SM
STEP MOTHER
FM
FOSTER MOTHER
SS
STEP SISTER
FT
FOSTER SISTER
SN
STEP SON
FS
FOSTER SON
UM
UNACCOMPANIED MINOR
FR
FRIEND
UN
UNCLE
GD
GRANDDAUGHTER
UR
UNRELATED
GF
GRANDFATHER
US
HUSBAND'S SISTER
GM
GRANDMOTHER
WB
WIFE'S BROTHER
GS
GRANDSON
WI
WIFE
GR
GREAT GRANDDAUGHTER
WS
WIFE'S SISTER
GH
GREAT GRANDFATHER
GG
GREAT GRANDMOTHER
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OMB APPROVAL NO.1405-XXXX
EXPIRES: XX-XX-20XX
ESTIMATED BURDEN: 120 minutes *
U.S. Department of State
AFFIDAVIT OF RELATIONSHIP FOR MINORS WHO ARE NATIONALS OF
EL SALVADOR, GUATEMALA, OR HONDURAS
Date Completed (dd mmm yyyy) Case File ID Number (Alien Number)
Name of National Resettlement Agency
Affiliate ID Number
IMPORTANT NOTICE: By completing this form you are claiming a relationship with children abroad in order to assist the U.S. Government in
determining whether those children meets one of the eligibility requirements to apply for admission to the United States under the U.S. Refugee
Admissions Program. The AOR itself is not an application on behalf of your children for admission to the U.S. as a refugee under the U.S. Refugee
Admissions Program or a petition for any immigration benefit under U.S. law. Completion of this AOR does not guarantee that your children will be
found qualified to apply for refugee admission or that they ultimately will be admitted to the United States. Additionally, the information listed in this
AOR may be used and disclosed by the U.S. Department of State as described in the Privacy Act statement below. The U.S. Government investigates
claimed family relationships and verifies the validity of documents. Criminal prosecutions may be sought when family relationships are falsified to
obtain immigration benefits.
SECTION I: INFORMATION ABOUT YOU, THE THE QUALIFYING PARENT
(a) Your Name (Last, First, Middle)
(c) Sex
(b) Your Date of Birth (dd mmm yyyy)
(d) Current Marital Status
Male
Female
Single
Married
(e) Current Spouse (Last, First, Middle)
Divorced
Separated
Widow(er)
(f) Your City/Country of Birth
(g) Current U.S. Address
Street
City
State
ZIP
(h) Phone Number
Home
(i) E-mail Address
(k) Your Current U.S. Immigration Status
Work
Cellular
(j) Your Date of Arrival in the U.S. (dd mmm yyyy)
(l) Date your current status was granted (dd mmm yyyy)
(m) Your Nationality
Privacy Act Statement
AUTHORITIES: The information is sought pursuant to the immigration laws contained in Title 8, United States Code, Section 1157.
PURPOSE: The information solicited on this form, including the agreement of the qualifying parent who claims a biological relationship to provide a
DNA sample at a later date, will be used to assist in determining whether a child claimed on this form is qualified to apply for access to the U.S.
Refugee Admissions Program (USRAP) for purposes of family reunification.
ROUTINE USES: The information on this form may be shared with the U.S. Department of Homeland Security (DHS) for purposes of determining
whether the child(ren) are eligible for admission to the United States. It may also be shared with DHS to verify the information provided by the
child(ren) listed on this form in any application they may make for admission to the United States under the USRAP or for any other immigration benefit
under U.S. law. The information may also be made available to a) Members of Congress; b) Federal, State, and local government agencies having
statutory or other lawful authority, as needed for the formulation, amendment, administration, or enforcement of immigration, nationality, and other laws
of the United States; c) international organizations; and d) resettlement agency partners that work with the USRAP to enable them to coordinate and
manage refugee processing overseas and resettlement in the United States. More information on the Routine Uses for the system can be found in the
System of Records Notice State-59, Refugee Case Records.
DISCLOSURE: Providing this information is voluntary. Failure to provide the information requested on this form may result in denied consideration for
access to the USRAP for refugee resettlement.
Paperwork Reduction Act
Public reporting burden for this collection of information is estimated to average 120 minutes per response, including time required for searching
existing data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection.
You do not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy
of this burden estimate and/or recommendations for reducing it, please send them to: U.S. Department of State, PRM/A, 2025 E Street, NW
Washington DC, 20520. OMB No. 1405-0206.
DS-7699
09-2016
Page 1 of 4
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
SECTION II: INFORMATION ABOUT QUALIFYING CHILD SEEKING ACCESS TO THE USRAP
A. You may claim only unmarried children under age 21 as Qualifying Children
Name
Last
Sex
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Relationship to Qualifying Parent
Upload
Photo
Sec II
Photo
Page
1
CONTACT INFORMATION FOR THE QUALIFYING CHILD LISTED ABOVE
Street Address
City
State/Province
Telephone Number
Cellular Phone Number
Postal Code
Country
E-mail Address
CONTACT INFORMATION FOR CHILD'S GUARDIAN
Relationship To Child
Name
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
CONTACT INFORMATION FOR OTHER PARENT OF CHILD, IF NOT LISTED ABOVE
Relationship To Child
Name
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
For each entry, choose types B - F, if applicable.
Type
Sex
Name
Last
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Marital
Status
Date of
Marriage
(dd mmm
yyyy)
Relationship Relationship
Qualifying Upload
to Qualifying to
Child Listed Photo
Parent
Above
Sec II
Photo
Page
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Comments
ADD ADDITIONAL PAGES AS NEEDED FOR EACH ADDITIONAL QUALIFYING CHILD YOU ARE CLAIMING.
DS-7699
Page 2 of 4
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
SECTION II A: INFORMATION ABOUT QUALIFYING CHILD SEEKING ACCESS TO THE USRAP
A. You may claim only unmarried children under age 21 as Qualifying Children
Name
Last
Sex
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Relationship to Qualifying Parent
Upload
Photo
Sec II A
Photo
Page
1
CONTACT INFORMATION FOR THE QUALIFYING CHILD LISTED ABOVE
Street Address
City
State/Province
Telephone Number
Cellular Phone Number
Postal Code
Country
E-mail Address
CONTACT INFORMATION FOR CHILD'S GUARDIAN
Name
Relationship to Child
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
CONTACT INFORMATION FOR OTHER PARENT OF CHILD, IF NOT LISTED ABOVE
Name
Relationship to Child
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
For each entry, choose types B - F, if applicable.
Type
Sex
Name
Last
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Marital
Status
Date of
Marriage
(dd mmm
yyyy)
Relationship Relationship
Qualifying Upload
to Qualifying to
Child Listed Photo
Parent
Above
Sec II A
Photo
Page
2
3
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Comments
ADD ADDITIONAL PAGES AS NEEDED FOR EACH ADDITIONAL QUALIFYING CHILD YOU ARE CLAIMING.
DS-7699
Page 2a of 4
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
SECTION II B: INFORMATION ABOUT QUALIFYING CHILD SEEKING ACCESS TO THE USRAP
A. You may claim only unmarried children under age 21 as Qualifying Children
Name
Last
Sex
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Relationship to Qualifying Parent
Upload
Photo
Sec II B
Photo
Page
1
CONTACT INFORMATION FOR THE QUALIFYING CHILD LISTED ABOVE
Street Address
City
State/Province
Telephone Number
Cellular Phone Number
Postal Code
Country
E-mail Address
CONTACT INFORMATION FOR CHILD'S GUARDIAN
Relationship to Child
Name
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
CONTACT INFORMATION FOR OTHER PARENT OF CHILD, IF NOT LISTED ABOVE
Relationship to Child
Name
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
For each entry, choose types B - F, if applicable.
Type
Sex
Name
Last
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Marital
Status
Date of
Marriage
(dd mmm
yyyy)
Relationship Relationship
Qualifying Upload
to Qualifying to
Child Listed Photo
Parent
Above
Sec II B
Photo
Page
2
3
4
5
6
7
8
9
10
11
12
13
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19
20
Comments
ADD ADDITIONAL PAGES AS NEEDED FOR EACH ADDITIONAL QUALIFYING CHILD YOU ARE CLAIMING.
DS-7699
Page 2b of 4
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
SECTION II C: INFORMATION ABOUT QUALIFYING CHILD SEEKING ACCESS TO THE USRAP
A. You may claim only unmarried children under age 21 as Qualifying Children
Name
Last
Sex
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Relationship to Qualifying Parent
Upload
Photo
Sec II C
Photo
Page
1
CONTACT INFORMATION FOR THE QUALIFYING CHILD LISTED ABOVE
Street Address
City
State/Province
Telephone Number
Cellular Phone Number
Postal Code
Country
E-mail Address
CONTACT INFORMATION FOR CHILD'S GUARDIAN
Relationship to Child
Name
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
CONTACT INFORMATION FOR OTHER PARENT OF CHILD, IF NOT LISTED ABOVE
Relationship to Child
Name
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
For each entry, choose types B - F, if applicable.
Type
Sex
Name
Last
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Marital
Status
Date of
Marriage
(dd mmm
yyyy)
Relationship Relationship
Qualifying Upload
to Qualifying to
Child Listed Photo
Parent
Above
Sec II C
Photo
Page
2
3
4
5
6
7
8
9
10
11
12
13
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15
16
17
18
19
20
Comments
ADD ADDITIONAL PAGES AS NEEDED FOR EACH ADDITIONAL QUALIFYING CHILD YOU ARE CLAIMING.
DS-7699
Page 2c of 4
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
SECTION II D: INFORMATION ABOUT QUALIFYING CHILD SEEKING ACCESS TO THE USRAP
A. You may claim only unmarried children under age 21 as Qualifying Children
Name
Last
Sex
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Relationship to Qualifying Parent
Upload
Photo
Sec II D
Photo
Page
1
CONTACT INFORMATION FOR THE QUALIFYING CHILD LISTED ABOVE
Street Address
City
State/Province
Telephone Number
Cellular Phone Number
Postal Code
Country
E-mail Address
CONTACT INFORMATION FOR CHILD'S GUARDIAN
Relationship to Child
Name
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
CONTACT INFORMATION FOR OTHER PARENT OF CHILD, IF NOT LISTED ABOVE
Relationship to Child
Name
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
For each entry, choose types B - F, if applicable.
Type
Sex
Name
Last
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Marital
Status
Date of
Marriage
(dd mmm
yyyy)
Relationship Relationship
Qualifying Upload
to Qualifying to
Child Listed Photo
Parent
Above
Sec II D
Photo
Page
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Comments
ADD ADDITIONAL PAGES AS NEEDED FOR EACH ADDITIONAL QUALIFYING CHILD YOU ARE CLAIMING.
DS-7699
Page 2d of 4
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
SECTION II E: INFORMATION ABOUT QUALIFYING CHILD SEEKING ACCESS TO THE USRAP
A. You may claim only unmarried children under age 21 as Qualifying Children
Name
Last
Sex
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Relationship to Qualifying Parent
Upload
Photo
Sec II E
Photo
Page
1
CONTACT INFORMATION FOR THE QUALIFYING CHILD LISTED ABOVE
Street Address
City
State/Province
Telephone Number
Cellular Phone Number
Postal Code
Country
E-mail Address
CONTACT INFORMATION FOR CHILD'S GUARDIAN
Relationship to Child
Name
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
CONTACT INFORMATION FOR OTHER PARENT OF CHILD, IF NOT LISTED ABOVE
Relationship to Child
Name
Street Address
Telephone Number
City
Cellular Phone Number
State/Province
E-mail Address
Postal Code
Country
For each entry, choose types B - F, if applicable.
Type
Sex
Name
Last
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Nationality
Marital
Status
Date of
Marriage
(dd mmm
yyyy)
Relationship Relationship
Qualifying Upload
to Qualifying to
Child Listed Photo
Parent
Above
Sec II E
Photo
Page
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Comments
ADD ADDITIONAL PAGES AS NEEDED FOR EACH ADDITIONAL QUALIFYING CHILD YOU ARE CLAIMING.
DS-7699
Page 2e of 4
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
SECTION III: INFORMATION ABOUT ALL OF YOUR RELATIVE(S) NOT PREVIOUSLY PROVIDED IN SECTION II
In this section please provide information about your current and former spouses and children (including biological, adopted, step and foster children); if you have NOT
previously provided this information under Section II. Please list whether living (L), deceased (D), or unknown (U). If the relative is deceased, please indicate the date of
death in the Current or Last Known City/Country column.
(A) SPOUSES (CURRENT AND FORMER)
Date of Birth
(dd mmm yyyy)
If estimated,
check box
Name
Last
First
Middle
City/Country
of Birth
Marital
Status
(Select
One)
Date/Place of Marriage
(dd mmm yyyy)
If estimated,
check box
Date of Marriage
Termination
(dd mmm yyyy)
If estimated,
check box
Current or Last
Known
City/Country
L,
D,
U
1
2
3
4
5
6
(B) CHILDREN (Biological, Adopted, Step and Foster Children) (PLEASE LIST OLDEST TO YOUNGEST)
Sex
Name
Last
First
Middle
Date of Birth
(dd mmm yyyy)
If estimated,
check box
City/Country
of Birth
Marital
Status
Current or Last
Known City/Country
L,
D,
U
Relationship
to Qualifying
Parent
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
DS-7699
Page 3 of 4
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
SECTION IV: ADDITIONS/EXPLANATIONS
Identify for which section, number and name the information is being provided.
SECTION V: SIGNATURES
I certify, under penalty of perjury under the laws of the United States of America, that all of the foregoing information given in this affidavit is true and
correct to the best of my knowledge. I understand that the information listed in this Affidavit of Relationship may be used by the U.S. Department of
State or the U.S. Department of Homeland Security in the manner described in the Privacy Act statement.
By submitting this Affidavit of Relationship I understand that I and certain biologically Qualifying Children (unmarried children under age 21) may be
requested to submit DNA evidence to verify our claimed family relationships. I agree to pay all necessary fees associated with that expense and the
expenses associated with the submittal of DNA evidence by any of the biologically Qualifying Family Members I am claiming on this form. I further
understand that DNA testing may be requested between my biologically Qualifying Children and their derivative beneficiaries at no expense to the
U.S. Government. I also understand that my family members may not be considered qualified to apply for refugee resettlement if I, or they, fail to
submit DNA evidence upon request.
Your Signature
Print Name
Date (dd mmm yyyy)
NAME AND SIGNATURE OF PERSON WHO ASSISTED IN PREPARING THIS FORM
I affirm that I assisted the Qualifying Parent listed above in completing this form and that the Qualifying Parent listed above provided valid
identification issued by a U.S. federal or state agency.
Signature
Affiliate Name and Address
DS-7699
Print Full Name
Date (dd mmm yyyy)
Phone Number
Page 4 of 4
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
Section IMAGES - Section II
II
QUALIFYING CHILD
Name
DOB
Name
Rel To QP
Name
DOB
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Photo Page 1 of 6
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
Section IMAGES - Section II A
II A
QUALIFYING CHILD
Name
DOB
Name
Rel To QP
Name
DOB
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DOB
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Photo Page 2 of 6
Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
Section IMAGES - Section II B
II B
QUALIFYING CHILD
Name
DOB
Name
Rel To QP
Name
DOB
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DOB
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DOB
Name
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Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
Section IMAGES - Section II C
II C
QUALIFYING CHILD
Name
DOB
Name
Rel To QP
Name
DOB
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DOB
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Name
Rel To QCH
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Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
Section IMAGES - Section II D
II D
QUALIFYING CHILD
Name
DOB
Name
Rel To QP
Name
DOB
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DOB
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Name
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Qualifying Parent Name (Last, First, Middle)
Case File ID Number
Date of Birth (dd mmm yyyy)
Section IMAGES - Section II E
II E
QUALIFYING CHILD
Name
DOB
Name
Rel To QP
Name
DOB
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Name
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| File Type | application/pdf |
| File Title | DS-7699 |
| Author | A/GIS/DIR |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |