Office of Refugee Resettlement Waiver Request Form

Generic for ACF Program Monitoring Activities

Waiver Request Form__06252021

Office of Refugee Resettlement Waiver Request Form

OMB: 0970-0558

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0970-0558 can be found here:

2025-06-02 - No material or nonsubstantive change to a currently approved collection
2025-03-28 - No material or nonsubstantive change to a currently approved collection

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