DS2019 Request Form Survey

STOP please read before proceeding!

Please do not fill out this form if you are holding a valid DS-2019. Only use this form if your DS-2019 is lost/damaged and/or you NEED the address updated on your current DS-2019 for legal documentation. (Remember that the DS-2019 form is still valid even if the host family information is not up to date. PLEASE DO NOT REQUEST A NEW DS-2019 FORM IF IT IS NOT NECESSARY)

If you ONLY need a travel validation signature to travel internationally, please use the travel validation form (found on your Au pair portal) and NOT THIS SURVEY. Thank you!

1.Au Pair In America ID Number

2.First Name(Required.)

3.Last Name(Required.)

4.SEVIS ID Number (found at the top of your DS 2019 form starting with a letter and 11 characters long)

5.Email Address

6.Reason for DS-2019 Reprint

Damaged/Lost

Current Host Family Changed Address

Rematched with New Host Family and need Updated DS2019 for DMV or Proof of Residence

New HF Extension Match (your extension year must have started in order for the Department of State system to update your DS with your new address)

7.As a reminder, the governmental SEVIS system dictates that the DS-2019 record needs to remain current at all times, meaning that we are not allowed to update the address on the document/in the au pair’s record until the au pair physically moves to the new host family’s location. Therefore, please do not request your DS-2019 reprint until after you move to your new residence

Yes, I confirm my match has started already and I am currently living with my new host family

No, I have not yet moved to my new host family and will resubmit this form after I have moved to this family

8.Current Host family's Last name(Required.)

9.Does Your DS2019 Need A Signature for Travel?

Yes

10.What Country Are you Traveling To?

11.Dates of Travel?

12.Please confirm the address that should be listed on the new DS-2019 document. This should be your current address.(Required.)

Street Address

City

State

Zip Code

Thank you for completing our survey! Your submission has been received. You will receive your document back within 1-3 weeks of the submission date. If there are any questions, we will contact you. Otherwise, we ask for your patience as we process a high volume of these requests. Please only submit your survey once, as multiple submissions can cause confusion and further delays.