Embassy Sanaʽa

Mission Policy

MP 01 Date: October 9, 2019

SUBJECT: Special Immigrant Visa

Distribution: All Personnel, All Agencies – Embassy Sanaa

// Supersedes & Updates Mission Policy 14-21, dated October 18, 2014 //

Refs: 9 FAM 502.5-3(B); 3 FAM 7715 SPECIAL IMMIGRANT STATUS

I. Scope

The Immigration and Nationality Act, as amended, provides special immigrant status for “an
immigrant who is an employee, or an honorably retired former employee, of the U.S.
Government abroad, and who has performed faithful service for a total of fifteen years, or
more, and his/her accompanying spouse and children: Provided, that the principal officer of a
Foreign Service establishment, in his discretion, shall have recommended the granting of a
special immigrant status to such alien in exceptional circumstances and the Secretary of State
approves such recommendation and finds that it is in the national interest to grant such
status.” (See 9 FAM 502.1-2(A) Related Statutory and Regulatory Authorities; also see 8 U.S.C.
110.1.)

A Special Immigrant Visa is not an entitlement for certain employees of the U.S. Government
abroad. Rather, it is a program to reward employees who have completed 20 years of regular
service or have provided at least 15 years of service to the United States Government and
have performed service under “exceptional circumstances.”

II. Eligibility

A. The following U.S. Government employees are generally eligible for SIV consideration:

1. Direct-hire (FSN) employees of any United States Government (USG) agency;

2. Persons employed by a USG agency under a Personal Services Contract (PSC) or Personal
Services Agreement (PSA);

3. Persons from categories (1) and (2) above who were honorably retired or whose
termination is a result of reduction-in-force, separation due to age, voluntary retirement, or
resignation for personal reasons can be considered "honorably retired." The length of service
requirements nonetheless must still be met.

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B. The following persons are not eligible:

1. Domestic employees, including those employed at the Chief of Mission Residence,

Deputy Chief of Mission Residence, and Agency heads.

2. Persons who work at the Mission as private contractors, i.e. who are not direct hire U.S.
Government employees.

3. Employees of the Mission entertainment or recreation or ancillary associations such as the

American International School or the American Employees’ Recreation Association.

4. Former USG employees who were separated from service but not within the meaning of
“honorably retired”, in other words, employees who were removed for cause or resigned in
lieu of removal.

C. Eligible Members of the Family:

1. One (1) spouse of the applicant.

2. Unmarried children, who are not older than 21 years of age at the time the Consular
Officer, acting on behalf of the Secretary of State, approves the DS-1884 visa petition.

3. The spouse and/or qualified child of an employee, who chooses not to travel with the
employee at the time, can join the employee at a later date (within the validity of the visa) as
long as s/he is considered eligible for immigration to the United States.

III. Eligibility Criteria, as listed in 9 FAM 502.5-3(B)

All the following requirements must be met by each applicant:

Length of Service: The applicant must have been employed abroad by the U.S. Government
for at least 15 years with “Exceptional Circumstances”. (see below) OR 20 years of regular
service.

The employment need not be continuous, in the same country, or with the same agency. An
applicant's employment needs not have all been in one category. That is, service as a PSC
and subsequent service as a direct-hire (FSN) or PSA would be added together to achieve the
length of service requirement. Although the total employment period must equal at least 15
years of full-time service, the employee need not have worked full-time throughout the
period.

For example, if the employee worked full-time for 10 years and half-time for at least 10 more,
that equivalent of 15 years of full-time employment would qualify the employee for
consideration. Official records must be used to establish the period of time served with the
U.S. Government.

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2. Faithful Service: It must also be established that the applicant performed faithfully.
While the Chief of Mission has primary responsibility for determining whether the applicant's
service has met this requirement, the Mission’s Special Immigrant Visa Committee should
appraise the entire performance records, including evaluations, awards, and disciplinary
actions. The Committee will pay particular attention to the recent performance appraisals and
give significant consideration to those employees who have had summary performance rating
of “good” or better. Disciplinary actions do not automatically disqualify the employee. The
Panel and the Chief of Mission should assess the importance of any such disciplinary actions
in light of the gravity of the reasons for the disciplinary action and whether the record as a
whole is one of faithful service.

3. Exceptional Circumstances: The Chief of Mission’s recommendation that an alien be

granted special immigrant status under INA 101(a) (27) (D) must be made in “exceptional
circumstances”. There is no specified form for such recommendation but the
recommendation must include the elements itemized in 9 FAM 502.5-3(C)(3). However,
Congress clearly did not intend that an employee be granted the benefits of INA 101(a) (27)
(D) simply as recognition for the requisite 15 years of service. To claim “exceptional
circumstances” the applicant must indicate which category is applicable to his/her request by
completing the attached SIV worksheet and by providing appropriate support documentation.

The following categories represent longstanding criteria used to determine whether there were
“exceptional circumstances” present in an employee’s case. In preparing recommendations
to the Department, the Mission must submit documentation that strongly indicates there were
exceptional circumstances that meet the criteria below. Those containing only anecdotal
recommendations or letters of recommendation that do not clearly contain any of the
following criteria will not normally satisfy the “exceptional circumstances” requirement and
will be returned to post for further consideration.

“Exceptional Circumstances” fall broadly within three categories and are explained in more
detail below:

(1) “Exceptional circumstances” of a prima facie nature

(2) Cases that strongly merit consideration of a finding of “exceptional circumstance”;

and

(3) Cases which demonstrate other bases for a finding of “exceptional circumstances”.

Exceptional Circumstances of a Prima Facie Nature: The Chief of Mission’s

recommendation should describe the exceptional circumstances in full detail. The following
factors are illustrative of situations in which an employee’s service with the U.S. Government
may be deemed to have “exceptional circumstances” of a prima facie nature.

(1) Relations between the employee’s country of nationality and the United States have
been severed;

(2) The country in which the employee was employed and the United States have severed
diplomatic relations; and/or

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 (3) The country in which the employee was employed and the United States have strained
relations and in which the employee may be subjected to persecution by the local government
merely because of association with the U.S. Government, or where the circumstances are such
that the employee may be pressured to divulge information available to him which would be
contrary to U.S. national interests.

(4) The alien was hired as an employee at the Consulate General at Hong Kong on or before
July 1, 1999 and has at least 15 years of faithful service. (99 State 124186)

Cases Strongly Meriting Consideration based on “Exceptional Circumstances."

In some cases, an employee has in the course of "faithful service" fulfilled responsibilities or
rendered service so far beyond the call of duty that some form of recognition is merited. If
circumstances such as those mentioned below are present in a case, the Chief of Mission’s
recommendation should address the circumstances in detail. Circumstances, such as the
following, would definitely meet the “exceptional circumstances” requirement:

(1) The employee has served the U.S. Government loyally and efficiently and you
believed that continued service to the U. S. Government might endanger the life of the
employee; and,

(2) The employee has, in the course of faithful service, fulfilled responsibilities or given
service in a manner that approaches the heroic. Obvious examples are prevention of a
physical attack on a U. S. official or citizen at the risk of an employee’s own life, or
protection of U.S. property in time of war, uprising, natural disaster, or other grave local
disturbance.
Other Exceptional Circumstances Cases - Service Beyond the Call of Duty
Service “beyond the call of duty” can encompass fewer spectacular activities than those
referred to above. In determining whether there are “exceptional circumstances” present, it
may be useful to assess the applicant's service to the U.S. Government in light of the
following factors which sometimes individually, but typically in combination, constitute
“exceptional circumstances.” Examples include, but are not limited to, the following:

(1) The employee has served as an employee of the U.S. Government in a faithful and
competent fashion for a period substantially exceeding the 15-year statutory minimum. The
extent to which other factors are indicative of "exceptional circumstances" would have to be
established according to how much time an employee has in service above the 15-year
minimum. In the case of an employee with 15 years of service, “exceptional circumstances”
would not be found without a substantial showing of factors such as those listed below.

In general, it is not necessary for such an employee to have risked his or her life in the line of
duty, nor is it necessary for such an employee to have worked for 20 or more years. On the
other hand, we will give particular consideration to cases involving the excellent service of an
employee with 20 or more years of employment in the U.S. Government -- a period
substantially exceeding the statutory minimum.

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 (2) The employee has (or has had) high visibility in a sensitive position, and the employee’s
performance as a representative of the U.S. Government in contacts with host government
entities and other organizations has brought great credit to the agency by which employed;

(3) The employee's position with the U.S. Government requires control over key aspects
of the operations of a Foreign Service post, and, thus, the overall functioning of the post. As
an example, control over the finances of a post would be a favorable consideration. The
Department will give particular consideration to an employee whose performance has resulted
in substantial monetary savings for the U.S. Government or has yielded other significant
benefits;

(4) The employee has been given individual awards in recognition of skill and personal
usefulness to the U.S. Government. The merit of such awards is increased if it is apparent
that there is a pattern of sustained high performance. If an employee has received such an
individual award, his or her nomination for an SIV could be approvable on that basis. The
Department will give less consideration to awards granted on a group basis, because such
awards have limited utility in establishing that any of the recipients is sufficiently exceptional
on his or her own to warrant classification under INA 101(a)(27)(D);

(5) The employee has, apart from performance of official duties, rendered valuable
services and assistance to the U.S. community at post, including activities undertaken after
termination of the employee’s official employment relationship with the U.S. Government;

(6) The employee has served for an extended time in a responsible position in a country
foreign to that employee, has thereby lost economic and social ties in the home country, and
thus might find it extremely difficult to be at ease in either the country of service or the home
country after retiring, or virtually impossible to find suitable employment if that is necessary
or desirable.

D. Immediate Intent to Immigrate:

Special immigrant status was not designed for use as an insurance policy to protect an
employee against the possibility of political or economic vicissitudes in the future. Nor was it
the intent of Congress that the principal employee obtains special immigrant status solely to
facilitate the entry of dependents into the United States when it is the principal employee’s
intent to return abroad to resume employment with the U.S. Government. For these reasons,
the regulations in 22CFR 42.32(d) (2) (i) (A) limit the validity of special immigrant status to
one year and that of the petition to six months. Generally, a post should refrain from
submitting a recommendation for special immigrant status to the Department until such a time
as the employee has:

(1) Established an intention to resign the position being held; and,

(2) Demonstrated an intention to immigrate to the United States within a designated

period of time.

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 Note: Even if the Department of State approves Special Immigrant status, the employee
and the employee’s eligible family members must still meet all other requirements
applicable to immigrant visa applicants, including those related to the medical clearance,
public safety, security, and public charge provisions.

IV. Procedures

A. The Applicant will (unless retired) complete and provide to his/her American
Supervisor:

1. Application for Special Immigrant Visa (attachment 1),

2. Special Immigrant Questionnaire (attachment 2),

3. Provide in support of the application, information that may not be available in official
records, and details of exceptional circumstances not covered elsewhere.

4. Provide a memorandum stating his/her intent to resign upon receiving the SIV.

B. The American Supervisor will:

a) Complete the Special Immigrant Analysis (attachment 3),

b) Attach these to the applicant's request either supporting and recommending

consideration of the request by giving details on the employee's faithful service,
sustained high performance, special acts, and/or exceptional circumstances OR
recommending against the request and explaining why the SIV should not be granted.
Agency head’s approval must be obtained in either case.

c) Send the applicant's request and a letter of recommendation to the Human Resources
Office.

C. The Human Resources Office will:

a) Review the application to ensure that it meets the requirements.

b) Prepare a memorandum for the SIV Committee of the applicant’s service history, a list
of awards, a detailed list of all performance appraisal ratings, and any other pertinent
information that is in the employee’s official personnel folder. If the applicant is a
retired employee, the Human Resources Office will request the employee's official
personnel folder to extract from it the necessary information.

c) Set a date and provide all necessary logistics for the SIV Committee to meet and
review the applications.

D. Mission SIV Committee:

a. The Mission SIV Committee will convene to review all applications. The Committee will
meet following these deadlines.

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b. The Committee will assure that applications are considered in a uniform and just manner
in accordance with applicable regulatory criteria. Forward its recommendation to the Chief of
Mission based on the information provided by the applicants, the American supervisors, and
HR Office. If the Committee recommends against submitting an employee’s name to the
Department, it will inform the Chief of Mission of its findings.

c. The Committee will be chaired by the Management Counselor or her/his designee. Other
voting committee members will consist of the USAID, DAO, and PAO.
d. The Country Consular Coordinator (CCC) and the Human Resources Officer (HRO) are
non-voting members. The HRO presents the cases and responds to HR questions, and the
CCC responds to Consular questions.

e. Upon final adjudication by the COM, all applications will be returned to the Human
Resources Officer. The Human Resources Officer will ensure that applications recommended
for approval are forwarded to the Consular Section as appropriate. For any applications not
approved, a letter will be sent to the applicant.

The establishment of the Committee is to ensure equal treatment of employees of all agencies
and to exercise uniformity of approach in all cases reviewed, especially the preliminary
determination of the existence of the required exceptional circumstances. This determination
can be of great assistance to the COM in deciding whether to recommend granting special
immigrant status. Decisions of the Committee are made by majority vote. SIV Committee
meetings are closed sessions. All discussions in an SIV Committee meeting are considered
sensitive and will not be discussed with parties not in attendance.

E. The Chief of Mission:

The Chief of Mission retains ultimate authority to make recommendations to the

Department for special immigrant status and is not bound by the recommendation of the SIV
Committee. In other words, the SIV Committee may recommend an applicant for SIV status,
but the Chief of Mission may decide not to recommend such status to the Secretary of State.

If the Chief of Mission decides to recommend that the employee be granted special
immigrant status, he/she should sign a letter of recommendation. Post must submit the
recommendation and evidence to support the recommendation to the Bureau of Consular
Affairs (CA/VO/L/A). The recommendation must include:

• The name and date and place of birth of the principal applicant and any immediate family
members accompanying employee;
• The length of time the alien has been in the employ abroad of the U.S. Government and
the agency or agencies concerned, with appropriate employment dates and places;
• The present employment status of the alien and, if not employed the reasons and
circumstances surrounding the alien’s departure from the last U.S. Government position;
• In the case of an alien qualifying for status under section 152 of the Immigration Act of
1990, evidence of a clear threat due to U.S. Government employment; and,
• Certification of Employee’s active intent to pursue immigrant visa application.

F. The Consular Section Will:

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1. Submit the applications to the Department of State on behalf of the Chief of Mission.

G. Department Review (CA/VO/L/A):

The Department of State (CA/VO/L/A) will determine each case upon its individual merits.
The Department of State may decide not to grant special immigrant status to an applicant,
even after the Chief of Mission has recommended such status be granted. The Mission will
submit supporting documentation to ensure that the Department has sufficient information on
which to base a decision. In determining whether an employee meets the “exceptional
circumstances" requirement, the Department uses the standards cited in 9 FAM 42.32(d) (2)
N6.5. The Mission must submit evidence that clearly relates to the factors cited in the note,
and should avoid general narrative descriptions of the employee's service history. If the
evidence fulfills the requirements of the law and the Department determines that the granting
of Special Immigrant Status is in the national interest, the State Department will inform the
Mission by cable of approval. The Consular Officer will then instruct the employee to file a
form DS-1884 “Petition to Classify Special Immigrant under INA 203(b) (4) as an employee
or former employee of the U.S. Government abroad.” Department of State approval is valid
for one year. Once filed and approved, the petition is valid for six months. The employee
must apply for the visa during this period.

H. The Consular Section Will:

At this point, the applicant may request to move the petition to another post.

1. Conduct the immigrant visa interview according to usual consular procedures, i.e., the
applicant must qualify to immigrate to the United States, according to the Immigration and
Nationality Act.

2. Notify the applicants through the Human Resources Officer of the Department’s decision
and if the Department approves SIV status, begin the immigrant visa process which includes
the submission of all applicable forms, an interview and a security review.

Note: Once the visa has been issued and the applicant wishes to delay departure beyond the
validity period of the visa, and the principal officer concludes in a particular case that the
delay has been or would be in the national interest, the principal officer should state this in the
request to the Department to extend the validity of the visa and recommend an extension of
validity.

I. The Applicant, if the application is approved, must:

1. File a form DS-1884 with the Consular Section. “Petition to Classify Special Immigrant
under INA 203(b)(4) as an employee or former employee of the U.S. Government
abroad.” Department of State approval is valid for one year. Once filed and approved, the
petition is valid for six months. The employee must apply for the visa during this period.

2. Retire or resign not later than the date of issuance of the SIV.

(9) The Human Resources Office will:

1. Ensure that the applicant submits a letter of intent to resign/retire to HR Office.

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2. Ensure that a copy of this letter is placed in the employee’s official personnel folder and
another copy forwarded to Consular Office for his/her file.

NOTE: If the employee is in active employment status, s/he must retire/resign within six
months of the date of the filing of the DS-1884. The application will not be further
processed without such a declaration from the applicant.
Attachments:

1. Special Immigrant Visa Worksheet – Attachment 1

2. Exceptional Circumstances Form by applicant – Attachment 2
3. Special Immigration Analysis Form by supervisor – Attachment 3
4. 9 FAM Regulations – Attachment 4
5. Checklist of Requirements – Attachment 5

Cleared: MC: RNicholson

Approved: DCM: JMunir

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 Attachment 1

SPECIAL IMMIGRANT VISA

WORKSHEET

Applicant Name: __________________________________________

(As written in the passport)

Date of Birth (dd/mm/yy): ______________________

Place of Birth (POB): ________________________________

Do you have a minimum of 15 years of USG employment: Yes:  No: 

Date employment began (dd/mm/yy) ___________________

Date employment ended (dd/mm/yy) ___________________

Telephone #: (Office) ____________________

(Home) ____________________

Name of Spouse:
__________________________________________________

Date of Birth of spouse (dd/mm/yy): _____________________

Place of Birth of spouse(POB): ___________________________

Name of Children: (include only those children who are under 21 years of age)

Child Name: ____________________________________

Date of Birth (dd/mm/yy): ___________________

POB: __________________________

Child Name: ______________________________________

Date of Birth (dd/mm/yy) ______________

POB: ________________________________

Child Name: _____________________________________

Date of Birth (dd/mm/yy): ________________

POB: _________________________________

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Child Name: _______________________________________

Date of Birth (dd/mm/yy) ________________

POB: _______________________

Child Name: _______________________________________

Date of Birth (dd/mm/yy) ________________

POB: ________________________

** ALL NAMES/BIRTHDATES OF DEPENDENTS MUST BE THE SAME AS

CONTAINED IN THE EMPLOYEE’S OPF

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 Attachment 2

Exceptional Circumstances Questionnaire

Complete this form only if the applicant has less than 20 years of service.

Please indicate whether any of the following factors relevant to determining "exceptional
circumstances" apply to you. If you answer "yes" as to any item, please submit a short
statement on a separate sheet of paper describing specifically how the particular factor applies
to you.

YES NO

1.   Did you serve during a period when diplomatic relations between your
country of nationality and the United States were severed?

2.   Did you serve during a period when diplomatic relations between the
country where you worked and the U.S. were severed?

3.   Did you serve in a country that had strained relations with the U.S., and
you faced harassment or possible persecution by the local government
merely because of association with the U.S. Government, or where the
circumstances are such that you may be pressured to divulge information
available to you which would be contrary to U.S. national interests?

4.   Did you serve the U.S. Government loyally and efficiently where it is
believed that your personal security might be endangered by continued
loyal service?

5.   Did you, in fulfilling your responsibilities, act "heroically?” Examples

include the prevention of a physical attack on an American official or
citizen at the risk of your own life, or protection of American property in
time of war, uprising, natural disaster, or other grave local disturbance.

6.   Have you performed work for the USG in a faithful and competent
manner for a period that substantially exceeds the fifteen-year statutory
minimum? In particular, do you have more than 20 years of USG service?

7.   Have you had high visibility in a sensitive position and has your
performance as a representative of the U.S. Government in contacts with
host government entities and other organizations brought great credit to
the employing agency?

UNCLASSIFIED
8.   Have you served in a position that has given you unique control over key
aspects of the operations of a Foreign Service post, and thus, the overall
functioning of a post? As an example, responsibility of an employee for
the finances of a post would be a favorable consideration. The weight
given to this factor will be increased upon a showing that the exercise of
skills has resulted in Substantial monetary savings for the U.S.
Government or has yielded other significant benefits.

9.   Have you received any awards in recognition of skill and personal

usefulness to the USG? If so, please specify whether the award(s)
was/were individual or group award(s). The weight given these awards
will be increased if it is apparent that they are reflective of a pattern of
sustained high performance. Conversely, awards granted on a group basis
have limited utility in establishing that ONE of the recipients of an award
meets the standard of an exceptional employee.

10.   Have you rendered valuable services and assistance to the American
community apart from your performance of official duties? Activities
undertaken after termination of Employment with the USG may be taken
into consideration.

11.   Have you served for an extended period of time in a responsible position
in a country that is foreign to you and have thereby lost economic or
social ties to your home country? A person in these circumstances might
find it difficult to be in either the country of service or the home country
after retiring or find suitable employment, if that is necessary.

UNCLASSIFIED
 Attachment 3

Special Immigrant Analysis Form

(To be filled by the applicant’s American Supervisor/Agency Head)

The Special Immigrant Visa Committee requests the following information from the
American closely supervising the applicant for a special Immigrant Visa.

1. Name of Applicant _______________________________________________

2. Name of American completing form _________________________________

3. Dates supervised applicant _________________________________________

4. Do you directly supervise employee? Yes _______ No ________

(If the answer to this question is yes, proceed to question 7.)

5. How many intermediate FSN supervisors are there? _________________

6. Do you feel that you work closely with the applicant to personally decide whether
his/her performance is outstanding, satisfactory, marginal, etc.?

Yes _________ No _________

7. How would you characterize the applicant’s overall level of performance during
the time you have supervised him/her?

Exceptional _____ Good _____Needs Improvement _____ Unsatisfactory____

Explain why you chose the category you did.

8. Is there any other matter at issue (either positive or negative) that you would like to
bring to the committee’s attention? For example, accusations, although not yet proven,
have been made that the applicant has used U.S. Government property for his/her own
gain, etc.

Agency Head Approval: _________________________________________________

Signed / Printed Name

UNCLASSIFIED
 Attachment 4

9 FAM 502.5-3(C)(2) “Exceptional Circumstances” Requirement

(CT:VISA-671; 11-18-2015)
The principal officer's recommendation that an alien be granted special immigrant status
under INA 101(a)(27)(D) must be made in “exceptional circumstances.” The legislative
history of this provision does not indicate specifically what such “exceptional circumstances”
might be. However, Congress clearly did not intend that an alien be granted the benefits of
INA 101(a)(27)(D) simply as recognition for the requisite years of service.
The following categories represent longstanding criteria used to determine whether there
were “exceptional circumstances” present in an employee’s case. In preparing
recommendations to the Department, Posts must submit documentation that strongly
indicates there were exceptional circumstances that met the below
criteria. Recommendations containing only anecdotal recommendations or letters of
recommendation that do not clearly contain any of the following criteria will not normally
satisfy the “exceptional circumstances” requirement and will be returned to post for further
consideration.

Categories of “Exceptional Circumstances”

(CT:VISA-1; 11-18-2015)
a. “Exceptional circumstances” fall broadly within three categories:
(1) “Exceptional circumstances” of a prima facie nature;
(2) Cases that strongly merit consideration of a finding of “exceptional circumstance”;
and
(3) Cases which demonstrate other bases for a finding of “exceptional circumstances”.
b. Cases falling under the first category will more likely be of an objective nature than
categories 2 and 3. Category 2 will be more objectively oriented than category 3. It is
important that the consular officer submit documentation which strongly indicates that there
were “exceptional circumstances” present in an employee’s case.

“Exceptional Circumstances” of Prima Facie Nature

(CT:VISA-1; 11-18-2015)
The principal officer's recommendation should describe the exceptional circumstances in full
detail. The following factors are illustrative of situations in which an employee’s service
with the U.S. Government may be deemed to have “exceptional circumstances" of a prima
facie nature:
(1) Relations between the alien employee’s country of nationality and the United
States have been severed;
(2) The country in which the alien employee was employed and the United States
have severed diplomatic relations;

UNCLASSIFIED
(3) The country in which the alien employee was employed and the United States
have strained relations and in which the employee may be subjected to persecution by the
local government merely because of association with the U.S. Government, or where the
circumstances are such that the employee may be pressured to divulge information available
to him which would be contrary to U.S. national interests; and/or
(4) The alien was hired as an employee at the Consulate General at Hong Kong on or
before July 1, 1999 and has at least 15 years of faithful service. (99 State 124186.)

Cases Strongly Meriting Consideration Based on “Exceptional Circumstances”

(CT:VISA-1; 11-18-2015)
In some cases, an employee has in the course of “faithful service” fulfilled responsibilities or
rendered service so far beyond the call of duty that some form of recognition is merited. If
circumstances such as those mentioned below are present in a case, the principal officer’s
recommendation should address the circumstances in detail. Circumstances, such as the
following, would definitely meet the "exceptional circumstances" requirement:
(1) The employee has served the U.S. Government loyally and efficiently, and the
consular officer believes that continued service to the U.S. Government might endanger the
life of the employee; and
(2) The employee has, in the course of faithful service, fulfilled responsibilities or given
service in a manner that approaches the heroic. Obvious examples are prevention of a
physical attack on a U.S. official or citizen at the risk of an employee’s own life, or
protection of U.S. property in time of war, uprising, natural disaster, or other grave local
disturbance.

Other “Exceptional Circumstances” Cases

(CT:VISA-1; 11-18-2015)
Service “beyond the call of duty” can encompass less spectacular activities than those
referred to in 42.32(d)(2) N6.5-3 above. In determining whether there are “exceptional
circumstances” present, consular officers should assess the applicant's service to the U.S.
Government in light of the following factors which sometimes individually, but typically in
combination, constitute “exceptional circumstances.” Examples include, but are not limited
to, the following:
(1) The employee has served as an employee of the U.S. Government in a faithful and
competent fashion for a period substantially exceeding the 15-year statutory minimum. The
extent to which other factors set forth in this note are indicative of "exceptional
circumstances" would have to be established according to how much time an employee has
in service above the fifteen-year minimum. For example, "exceptional circumstances" would
not be found unless there a substantial showing of factors such as those listed below in the
case of an employee with 15 years of service (and in whose case the factors listed in the
preceding note were lacking). On the other hand, the Department will give particular
consideration to cases involving the excellent service of an employee with 20 or more years
of employment in the United States Government -- a period substantially exceeding the
statutory minimum;

UNCLASSIFIED
(2) The employee has (or has had) high visibility in a sensitive position, and the
employee’s performance as a representative of the U.S. Government in contacts with host
government entities and other organizations has brought great credit to the agency by which
employed;
(3) The employee's position with the U.S. Government requires control over key aspects
of the operations of a Foreign Service post, and, thus, the overall functioning of the post. As
an example, control over the finances of a post would be a favorable consideration. The
State Department will give particular consideration to an employee whose performance has
resulted in substantial monetary savings for the U.S. Government or has yielded other
significant benefits;
(4) The employee has been given individual awards in recognition of skill and personal
usefulness to the U.S. Government. The merit of such awards is increased if it is apparent
that there is a pattern of sustained high performance. If an employee has received such an
individual award, his or her nomination for a Special Immigrant Visa (SIV) could be
approvable on that basis. The Department will give less consideration to awards granted on
a group basis, because such awards have limited utility in establishing that any of the
recipients is sufficiently exceptional on his or her own to warrant classification under INA
101(a)(27)(D);
(5) The employee has, apart from performance of official duties, rendered valuable
services and assistance to the U.S. community at post, including activities undertaken after
termination of the employee’s official employment relationship with the U.S. Government;
(6) The employee has served for an extended time in a responsible position in a country
foreign to that employee, has thereby lost economic and social ties in the home country, and
thus, might find it extremely difficult to be at ease in either the country of service or the
home country after retiring, or virtually impossible to find suitable employment if that is
necessary or desirable.

UNCLASSIFIED
 Attachment 5

DECLARATION OF INTENT TO IMMIGRATE

Name of Applicant: _____________________________________________

I hereby submit my application for a Special Immigrant Visa. I understand that if issued,
the visa must be used within six months from the date of issue. I also understand that
family members issued special immigrant visas must also use those visas within that time
frame. In the event that my family does not travel with me, they may be issued visas to
“follow to join” within one year. Should they not travel within the year, they may not be
able to travel under my immigrant status. The information contained in this application is
complete and accurate. I understand that the omission of information may delay my
application and that false or misleading information could disqualify me from
consideration. I agree to resign/retire my position if I am in active employment status no
later than the date of issuance of an immigrant visa to me.

Signature: _________________________________

Date Submitted: ___________________

UNCLASSIFIED
 CHECKLIST OF REQUIREMENTS FOR THE APPLICANT

1. Application for SIV through American Supervisor.

2. Complete the Special Immigrant Questionnaire.
3. Complete the Exceptional Circumstances form for SIV qualification in case you have
less than 20 years of service. (Definition of service is provided in the 9 FAM
attachment)
4. Attach a copy of your Performance Evaluation Reports for the last five years, awards,
letters of appreciation and training certificates.
5. Signed and witnessed statement of immediate intent to resign and immigrate per
attachment 5.

CHECKLIST OF REQUIREMENTS FOR THE AMERICAN SUPERVISOR

1. Nomination which should include a demonstration of Exceptional Circumstances as

defined in 9 FAM 42.32(d) (2) N.65, if applicable.

2. Complete the special Immigrant Analysis Form

UNCLASSIFIED