DS-4317 Family Reunification Assistance for Afghan Parolees' Imm

OMB Control No: xxxx-xxxx
Expiration Date: mm-dd-yyyy
Estimated burden: 30 minutes
Form DS-4317
Family Reunification Assistance for Afghan Parolees' Immediate Family
Members Outside the United States
The U.S. government may be able to offer departure assistance for certain family
members depending on your situation.
If you are an adult applying for family reunification assistance, please read
You may apply for your spouse and your unmarried children under the age of 21 who are
outside the United States if you are an Afghan national who entered the United States
under humanitarian parole and:
•
You currently remain a parolee; OR
•
You were paroled into the United States and subsequently granted Temporary
Protected Status (TPS).
With this assistance, your lawful spouse and your unmarried children under the age of 21
may be eligible for admission to the United States as refugees. You may apply for your
children who are unmarried and were under the age of 21 on August 14, 2021.
To request departure assistance for your eligible family members, complete the Form
DS-4317 through this website. The Department of State will contact you with departure
options for your family members after your Form DS-4317 has been received and your
parole has been verified. If the U.S. Government can help your family members depart
Afghanistan, your family members will travel to a country where they can be considered
for an immigrant pathway such as refugee status through the U.S. Refugee Admissions
Program(USRAP) or parole. Each family member will require a valid passport. Assistance
from the U.S. Government to depart Afghanistan is not a guarantee of admission or
parole into the United States by U.S. immigration officials. Each applicant must pass
security vetting before receiving approval to relocate to the United States. Claimed
familial relationships may be subject to DNA testing at the discretion of the U.S.
government.
To complete this form, please have the following document or information available:
•

Your Employment Authorization Document (EAD).

•

If you do not have an EAD, you will need your USCIS# (A-Number or Alien
Registration Number) and other documents, such as your Form I-94. For more
information on locating a Form I-94, see the Customs and Border Protection
(CBP) Form I-94 webpage for parolees.

Please also have the following documents available on behalf of your lawful spouse and
unmarried children under 21 years of age who are outside of the United States:
•
•
•
•

Marriage Certificate – for your lawful spouse*
Birth Certificate – for your children under the age of 21
Tazkera – for each family member
Passport (if available) – for each family member

Please note that, generally, only the lawful marriage of a polygamous marriage will be
considered valid for immigration purposes unless a divorce/death certificate can be
provided as evidence that a marriage has ended, along with a marriage certificate for
any subsequent marriages. Polygamy is the religious practice or historical custom of
having more than one spouse at the same time. Polygamous marriages are legal under
Afghan law, but they are illegal in all states in the United States. U.S. law does not
recognize polygamous marriages.
If you continue a polygamous marriage you were in before you came to the United
States or begin a new polygamous marriage in the United States, your immigration
application or petition may be denied. If you have questions about polygamous
marriage and U.S. immigration law, contact your local resettlement agency. If you need
to find legal services, please visit the USCIS Find Legal Services webpage.

If you are a minor applying for family reunification assistance, please read
The U.S. Government may be able to offer departure assistance for your family members
who are outside the United States and who are 1) your parent(s)/legal guardian(s),
and/or 2) unmarried sibling(s) who were under the age of 21 as of August 14, 2021, if you:
•
•
•

Arrived in the United States on or after August 14, 2021 ; AND
Were under the age of 18 upon arrival to the United States; AND
Have a parent or legal guardian who is outside of the United States

Afghans who meet the above requirements who were referred and those who were not
referred to the Office of Refugee Resettlement’s (ORR) Unaccompanied Children’s
Program are among those who may be eligible for assistance using this form. Generally,
these children resettled from the safe havens directly into communities with their
caregivers and would not have a Verification of Release (VOR) from ORR. Such children
may use this DS-4317 form to request that their parents or legal guardians, and their
sibling(s) who were unmarried and under the age of 21 as of August 14, 2021, be referred
to the U.S. Refugee Admissions Program (USRAP) to apply for classification as a refugee
for purposes of admission to the U.S., or to be considered for parole. Claimed familial
relationships may be subject to DNA testing at the discretion of the U.S. government.
To request departure assistance for your eligible family members, complete the DS-4317
through this website. The Department of State will contact you and will work to identify
possible departure options for your family members after your DS-4317 has been
received and your parole has been verified. If the U.S. Government can help your family
members depart Afghanistan, your family members will travel to a country where they
can be considered for an immigration pathway such as refugee status through the
(USRAP) or parole. Each family member will require a valid passport. Assistance from the
U.S. Government to depart Afghanistan is not a guarantee of admission or parole into
the United States by U.S. immigration officials. Each applicant for refugee admission or
parole must pass security vetting before receiving approval to relocate to the United
States.

To complete this form, please have the following documents or information available:
•

Your Employment Authorization Document (EAD) (if applicable)

•

If you do not have an EAD, you will need Your USCIS# (A-Number or Alien
Registration Number) and other documents, such as your I-94. For more
information on locating an I-94, see the Customs and Border Protection (CBP) Form
I-94 webpage for parolees.

• Name and contact information for person assisting the minor in completing the form,
if applicable.
Please also have the following documents available on behalf of your parent(s) and
eligible sibling(s):
•

•
•
•
•
•

Name of parent(s), legal guardian(s) and/or eligible sibling(s) and contact
information for the family members
Marriage Certificate – for your parent(s)
Birth Certificate – for yourself and your eligible sibling(s)
Tazkera – for each family member
Passport (if available) – for each family member
Legal custody order (if applicable)

Information About You
You can use your Employment Authorization Documents (EAD) to verify your
admission or parole when you complete this form. An EAD is an identity document
that USCIS issues to individuals with temporary authorization to work in the United
States. You may have applied for an EAD at a safe haven and later received it from
your resettlement agency. An EAD looks like this.

Do you have an EAD card?
YES NO
*All questions on this page and the next page
appear only for those applicants who select yes

What is your surname (last name)? x Required

What is your given name (first name)? x Required

What is your USCIS# (A-Number or Alien
Registration Number? x Required

Values can only be Numeric and have a minimum
length of 7 and a maximum length of 9 digits
Examples: 1234567, 12345678, 123456789

What is your Category? x Required

What is your Card #? x Required

Example: SRC0000000000 - Must start with 3 Letters
followed by 10 digits

What is your Date of Birth? x Required

Please enter date in mm-dd-yyyy format.
Ex: August 31st 1998 should read 08-31-1998

What is your Sex? x Required
--Select
M
F

Do you have an EAD card?
YES NO
*Only these four questions appear if the
applicant selects no.
What is your USCIS# (A-Number or Alien
Registration Number? x Required

Values can only be Numeric and have a minimum
length of 7 and a maximum length of 9 digits
Examples: 1234567, 12345678, 123456789
What is your surname (last name)? x Required

What is your given name (first name)? x Required

What is your Date of Birth? x Required

Please enter date in mm-dd-yyyy format.
Ex: August 31st 1998 should read 08-31-1998
What is your email address (if the application is
for a minor child, the caregiver should use their
email address)? x Required
Example: [email protected]
What is your phone number? x Required

Example: 8888888888 (numbers only)
Where do you live in the United States? Enter your ZIP Code.

Please use only the first five numbers of your ZIP Code. Example: 12345
If you arrived in the United States with a passport, what is your passport number?

Warning: Value Must be Alphanumeric and no more than 9
characters.

Additional Information About You
If you entered the United States with a passport, what is your passport number?

Warning: Value Must be Alphanumeric and no more
than 9 characters.
If you have a USCIS Receipt Number, what is your USCIS Receipt Number?

The receipt number is a unique 13-character identifier
starting with 3 letters that USCIS provides for each
application or petition it receives. It may look like:
IOE1234567890.
Allowed values:
•13 characters maximum
•3 leading letters
•followed by 10 numbers
What is your Administrative Arrival/Departure Record Number (Form I-94)?

The DHS arrival/departure record number appears on the Form I-94 issued to
noncitizens and consists of 11 characters.
It may look like: 123456789A1.
For more information on locating a Form I-94, see the Customs and Border
Protection (CBP) Form I-94 webpage for parolees or see Temporary Protected
Status (TPS) Webinar Questions and Answers (uscis.gov) for TPS recipients.
If you are also an SIV applicant, what is your case number?

SIV case numbers include numbers that may look like the following or something
similar and may contain up to 16 characters. The four kinds of case numbers are:
a."NVCSIV{year}{sequence}"
b."ASISIV{year}{sequence)"
c."LIN{year}{sequence}"
d."KBL{year}{sequence}"
What was your departure date from Afghanistan?

Please enter date in mm-dd-yyyy format.
Ex: August 31st 1998 should read 08-31-1998
What was your arrival date into the United States? Required

Please enter date in mm-dd-yyyy format.
Ex: August 31st 1998 should read 08-31-1998

Have you ever used any other names or nicknames and/or
dates of birth before? If no, then write None below. Required

Please enter date in mm-dd-yyyy format.
Ex: August 31st 1998 should read 08-31-1998

Information About Your Immediate Family Members Outside the United States
* Person Outside the United States x Required

Add New Person
What is this family member’s relationship to you? x Required
In cases of polygamy, only the first spouse may qualify as a spouse for family reunification.
--Select
Spouse – your husband of wife outside the United States
Child – your unmarried child under the age of 21 outside the United States
Sibling - your unmarried sibling under the age of 21 outside the United States
Parent – your parent(s) or legal guardian(s) outside the United States
What is their Surname (last name)?
x Required
Spelling should match the spelling on
family member's passport or tazkera.

What is their Given Name (first
name)? x Required
Spelling should match the spelling on
family member's passport or tazkera.

What is their Date of Birth? x
Required

What is their sex? X Required
--Select-Male
Female

Please enter date in mm-dd-yyyy
format.
Ex: August 31st 1998 should read
08-31-1998
* Preferred Spoken Language
--Select—
Dari
Pashto
English
Other
Which language? x Required (only shown if the applicant selects Other)

Passport #
A current passport is required for
travel. If your family member does
not have a passport, you may want
to apply for one to prepare for
potential travel.

Passport Expiration Date
Passports must be valid for at least
six months from the date of travel.
Potential travelers are encouraged to
seek an extension or renewal if
needed.

Information About Your Immediate Family Members Outside the United States
* Person Outside the United States x Required
Tazkera Number? x Required

What is their country of citizenship? x Required

What country are they currently in? x
Required

What city/town/village are they
currently in? x Required

* Contact Information x Required

This must be the contact information for travelers in Afghanistan and other third
countries. You should not provide the phone number of the person in the U.S..

Add Contact
Phone # Country

Phone # Country Prefix

Phone #

Email

Preparer’s Information
Did someone help you fill out this form? X Required
YES NO
You should answer NO to this question if you are the family member
* Name of the person who helped you prepare this form? x Required

* Business email address or best email contact of the person who helped you? x Required

* Relationship of preparer to the individual submitting this form? x Required
--Select—
NGO, including resettlement agencies
Family member
Friend
Volunteer or Advocate
Attorney

Privacy Act Statement for Family Reunification DS-4317 Form
AUTHORITIES: The information is sought pursuant to:
•5 U.S.C. 301 (Secretary of State's authorities with respect to management of the
Department of State);
•22 U.S.C. 2651a (Organization of the Department of State);
•8 U.S.C. 1101-1537 (Immigration and Nationality Act of 1952, as amended).

PURPOSE: This form will be used to collect information on Afghan nationals who may be
eligible for departure assistance for reunification with their family members already in
the U.S. The information furnished may also be used to verify the individuals' eligibility for
this assistance, refer them to the U.S. Refugee Admissions Program (USRAP), and
facilitate travel.
ROUTINE USES: The information on this form may be shared with the United States
Department of Homeland Security's U.S. Citizenship and Immigration Services (USCIS) to
determine an individual's eligibility for departure assistance, including whether there is
an existing family visa petition and if the underlying family relationship within the
petition has been reviewed. The information may also be made available to contractors
who assist with confirming Afghan nationals are ready to travel and facilitating that
travel. More information on the Routine Uses for the system can be found in the System
of Records Notice STATE-39, Visa Records.
DISCLOSURE: Providing this information is voluntary. Failure to provide the information
requested on this form may result in the U.S. government being unable to provide
departure assistance to your family members.
PAPERWORK REDUCTION ACT STATEMENT
Public reporting burden for this collection of information is estimated to average 30
minutes per response, including the time required for searching existing data sources,
gathering the necessary data, providing the information 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: PRA
Attorney, ATTN: 1405-0251, Office of the Legal Adviser/LM, Suite 4805, 2205 C Street NW,
Washington DC 20520.

Post-submission Message
Thank you for submitting this request for U.S. government departure assistance. Please
note that submission of your request does not guarantee the U.S. government will
facilitate the travel of your family members.
Requests will be reviewed in the order they were received to determine if family
members are eligible for departure assistance. If approved, eligible family members
must be ready to travel for the U.S. government to facilitate their travel from Afghanistan.
This may include the requirement of a passport or other travel document.
Please note: The Department of State maintains a Level 4 travel advisory for Afghanistan,
advising that individuals do not travel to Afghanistan due to civil unrest, armed conflict,
crime, terrorism, and kidnapping. Travel to all areas of Afghanistan is unsafe. The
Department of State assesses the risk of kidnapping or violence against U.S. citizens in
Afghanistan is high.
Applicants should not travel to Afghanistan to accompany the eligible family
member(s), and their physical presence will not facilitate nor expedite the U.S.
government's ability to support the request.