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NONIMMIGRANT VISAS
».
SPRING 2001
AGENT MANUAL
TABLE OF CONTENTS
I. Eligible Applicants 4
X.Processing Instructions
Diskette Labeling 22
Preparation for Embassy Drop off 23
Drop-off and Pick-up Instructions 24
4. Supporting Documentation
^^Prftfiffi^^^Si A1•'
g^J^
Dear Sir,
We kindly request your good office to grant a visit visa to USA for Mr.
iiOUXJOUOXJUXXXXXXX j wbo is working in our organization in the capacity of
Accountant since June, 1999 and his contract is renewed automatically after two
years.
His withdraws a monthly salary of 3000 SAR along with three months salary as a
housing allowance and 10% of bis basic salary as transport allowance. He is visiting
United States for a pleasure trip for 5 days during his annual leave.
He is an Egyptian national holding Egyptian passport no. 21193 issued at Cairo and
valid until 10th of April 2006.
We thank you in advance for your attention to the above, in the meantime please
accept our sincere regards.
Sincerely Yours
amedy
lations Mana
-9-
List of Required Documents per Visa Category
Visa Ol
Cat. F1/F2 H1B /O2
/ Bl C D Ml /H2A Jl I LI PI Rl
Req. /B2 /M2 /H2B /J2 /L2 /P2 /R2
Doc. /H3 /P3
/H4 /Ql
OF- V V V V V V V A/ V V
156
Photo V V V V V V V V V V
MRV V V V V V V V V V V
fee Note 1
Comp.
letter V V V V V
Note 2
Exit/
Reent V >/ V V V V V
(Non-
Saudi
s
only)
1-20 V
1-797 V V V
NoteS
1AP-
66 V
Invita
-tion >/
Letter
Other V V
NoteS , Note 4
Notes:
1. No MRV fee if IAP-66 issued by US Government agency
2. Bl for Saudi passport holders and B1/B2 for non-Saudis
3. Or approved Blanket Petition Notification
4. IRS tax exemption certification for the religious organization in the U.S.
5. Statement or other document describing the need for transit visa
i-i J-v-
PERSONS ACCOMPANYING
BEARER 'O?™? ASSPORT
Sample of an Official-Special
T udi Passport T " vv " '"'^ifcl
r^i .'-^;-
^12-
PLEASE TYPE OR PRINT YOUR ANSWERS IN THE SPACE PROVIDED BELOW EACH ITEM.
1. SURNAMES OH FAMILY NAMES (Exactly as in Passport) DO NOT WRITE IN THIS SPACE
OTHER: INA
10. NAME AND STREET ADDRESS OF PRESENT EMPLOYER OR SCHOOL REFUSAL REVIEWED BY
(Postal box number unacceptable)
n N0 D YES
HAVE YOU EVER APPUED FOR A U.S. IMMIGRANT VISA? 20. WHO WILL FURNISH FINANCIAL
SUPPORT, INCLUDING TICKETS?
Ll NO Ll YES
WHERE?
WHEN? 21. AT WHAT ADDRESS WILL YOU STAY
IN THE U.S.A.?
VISA WAS ISSUED Q VISA WAS REFUSED Q
18. DO YOU INTEND TO STUDY IN THE U.S.? Q NO Q YES 25. HAVE YOU EVER BEEN IN THE U.S.A.?
H YES, write name and address of school as it appears on form 1-20 Q| NO Q] YES
WHEN?
FOR HOW LONG?
28. WHERE HAVE YOU LIVED FOR THE PAST FIVE YEARS ? DO NOT INCLUDE PLACES YOU HAVE VISITED FOR
PERIODS OF SIX MONTHS OR LESS.
Countries Cities Approximate Dates
29. IMPORTANT: ALL APPLICANTS MUST READ AND CHECK THE APPROPRIATE BOX FOR EACH ITEM.
A visa may not be issued to persons who are within specific categories defined by law as inadmissible to the United
States (except when a waiver is obtained in advance). Are any of the following applicable to you ?
(• Have you ever been afflicted with a communicable disease o! public health significance,
a dangerous physical or mental disorder, or been a drug abuser or addict ? (212(aX1)) D YES D NO
o Have you ever been arrested or convicted for any offense or crime, even though subject
of a pardon, amnesty or other similar legal action ? Have you ever lawfully distributed or D YES •D NO
sold a controlled substance (drug), or been a prostitute or procurer lor prostitutes?
[212(aX2»
• Do you seek to enter the United States to engage in export control violations, subversive
or terrorist activities, or any other unlawful purpose ? Are you a member or
representative of a terrorist organization as currently designated by the U.S. Secretary of LJ YES D NO
State ? Have you ever participated in persecutions directed by the Nazi government of
Germany; or have you ever participated in genocide ? [212(aX3)]
• Have you ever been refused admission to the U.S., or the subject of a deportation
hearing, or sought to obtain or assist others to obtain a visa, entry into the U.S., or
sought to obtain a visa or any U.S. immigration benefit by fraud or willful D YES D NO
misrepresentation ? Have you attended a U.S. public elementary school on student (F)
status, or a public secondary school without reimbursing the school after November 30,
1996? [212(aX6)]
• Have you ever departed or remained outside the United States to avoid military service ? D YES D NO
[212(a)<8)J
O Have you ever violated the terms of a U.S. visa, or been unlawfully present in, or
deported from, the United States ? [212(a)(9)J D YES D NO
C Have you ever withheld custody of a U.S. citizen child outside the United States from z
person granted legal custody by a US. court, voted in the United States in violation of YES D NO
any law or regulation, or renounced U.S. citizenship for the purpose of avoiding taxation ?
(212(aX10)]
A YES answer does not automatically signify ineligibility lor a visa, but if you answered YES to any of the above, or rf
you have any question in this regard, a personal appearance at this office is recommended. H an appearance is not
possible at this time, attach a statement of facts in your case of this application.
30. I certify that I have read and understood all the questions set forth in this application and the answers I have furnished
on this form are true and correct to the best of my knowledge and belief. I understand that any false or misleading
statement may result in the permanent refusal of a visa or denial of entry into the United States. I understand that
possession of a visa does not entitle the bearer to enter the United States of America upon arrival at port of entry if he or
she is found inadmissible.
APPLICANTS SIGNATURE
H this application has been prepared by a travel agency or another person on your behalf, the agent should indicate
name and address of agency or person with appropriate signature of individual preparing form.
37 mm x 37 mm
I
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COMPUTER DATA ENTRY
Program Instructions
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*^'^_Jj^Uf_^i..*• ?*^a!>J!kiS?;'.j^'^j^Si^^-^S*-"--—.^~~-—A
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:- Default valuei: — —.-^-.^.~
_ Recoid|.l;[ 1 Eno«(i);| StalutiJHEW 1 POBrjSARB nationality: J S A R B V i s a Class: bljB2
:lmport Close
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Oescriplion: I
lTptJFJes.2
1. PASSPORT NUMBER
8. VISA CLASS
-BUSINESS/TOURISM -B1/B2
-MEDICAL -B1/B2
-TRANSIT - Cl
-CREW -D
-STUDY (FORM 1-20) -F1/F2
-VOCATIONAL STUDY (I-20M) -M1/M2
-TEMP. WORK (1-797) -H1B/H4
-MEDIA -I
-EXCHANGE VISITOR (IAP-66) -J1/J2
-INTRACOMPANY TRANSFEREES -L1/L2
-OTHER TEMP. WORKERS (1-797) -0,P,Q
-RELIGIOUS -R1/R2
2. Submission Date
Example:
A0000003
12345,TEST ONE,TEST ONE,01JAN1980,SARB,SARB,M,B1/B2,,,,,,,,,,
12345,TEST TWO,TEST TWO,01JAN1990,SARB,SARB, F, B1/B2,,,,,,,,,,
98765,TEST THREE,TEST THREE,01JAN2000,SARB,SARB,M,B1/B2,,,,,,
This p»9e roust be completed and signed in the U.S. by a designated school official.
4. Level of education the student is pursuing or will pursue in the United States: 8. This school has information showing the following as the student's means of
(creek onry one) support, estimated for an academic term of 9 months (Use the same
number of months given in item T).
a. Q Primary e r~| Master's
under penalty of perjury that al formation provided above in lexis 1 through 8 was completed before I signed this form and is true apd correct I executed this
review and evaluation h the United States by me or other officials at the school of the student's application. tmsuipts or other records of course* taken
'. which were received it the school prior to the execution of tnts form: the school has determined that the above named student's qualifications meet al
the student wS be required to pursue a fun ccuse of study as defined by B CFR 214.2(0(6); I am a designated official of the above named school
SzuOert Certtficatiorr. I have read and agreed to comply with the terms and conditions of my admission and those of any extension of stay as specified on page 2. I certify that afl information
fvtMOMJ on this form refers specifically to me and is true and correct to the best of my knowledge, I certify that I seek to enter or remain in the United States temporarily; and solely for
•fte pjpose of pursuing a Ml course of study at the school named on Page 1 of this form. I ateo authorize the named school to release any information from my records which is needed
toy ** 'NS pursuanWo 8 CFR 214_3<g) to determine my nonimmigrant status.
Name of student
^^rature ol parent of guaraian Name ol parent/guardian (prinl Of type) Address(aty) (State or province) (Country) (Date)
Irtucertfis uncer 18
For official use onty
Microfilm Index Nunber
B A-BA.20IO (Re
-25-
" Page 2
/(ty for.collecting the information on this and related student forms dent in an educational program and any period of authorized practical
stained in 8 U.S.C. 1101 and 1184. The information solicited will be training plus sixty days. While in the United States, you must main-
ii by the Department of State and the Immigration and Naturalization tain a valid foreign passport unless you are exempt from passport
j'~vice to determine eligibility for the benefits requested. requirements.
You may continue from one educational level to another, such as prog-
INSTRUCTIONS TO DESIGNATED SCHOOL OFFICIALS ressing from high school to a bachelor's program or a bachelor's pro-
gram to a master's program, etc.. simply by invoking the procedures for
1 Tie law provides severe penalties for knowingly and willfully fal- school transfers.
s ing or concealing a material fact, or using any false document
3. SCHOOL For initial admission, you must attend the school specified
it ic submission of this form. Designated school officials should con-
on your visa. If you have a Form 1-20 A-B from more than one school,
sutt regulations pertaining to the issuance of Form 1-20 A-B at 8 CFR
it is important to have the name of the school you intend to attend
2^.3 (K) before completing this form. Failure to comply with these reg-
specified on your visa by presenting a Form 1-20 A-B from that school to
u ons may result in the withdrawal of the school approval for atten-
the visa issuing consular officer. Failure to attend the specified school will
d ce by foreign students by the Immigration and Naturalization Service
result in the loss of your student status and subject you to deportation.
(B CFR 214.4).
4. REENTRY. A nonimmigrant student may be readmitted after a tem-
2 'SSUANCE OF FORM 1-20 A-B. Designated school officials may
porary absence of five months or less from the United States, if the stu-
is e a Form 1-20 A-B to a student who fits into one of the following
dent is otherwise admissible. You may be readmitted by presenting a
; {jories, if the student has been accepted for full-time attendance at
valid foreign passport, a valid visa, and either a new Form 1-20 A-B or
tie institution: a) a prospective F-1 nonimmigrant student; b) an F-1
page 4 of the Form 1-20 A-B (the 1-20 ID Copy) property endorsed for
T="sfer student; c) an F-1 student advancing to a higher educational
reentry if the information on the 1-20 form is current
e I at the same institution; d) an out of status student seeking reinstate-
T 1 The form may also be issued to the dependent spouse or child of 5. TRANSFER. A nonimmigrant student is permitted to transfer to a dif-
in F-1 student for securing entry into the United States. ferent school provided the transfer procedure is followed. To transfer
schools, you should first notify the school you are attending of the intent
ft^n issuing a Form 1-20 A-B, designated school officials should
to transfer, then obtain a Form 1-20 A-B from the school you intend to
:i iplete the student's admission number whenever possible to
attend. Transfer will be effected only if you return the Form 1-20 A-B to
!i jre proper data entry and record keeping,
the designated school official within 15 days of beginning attendance at
i. ENDORSEMENT OF PAGE 4 FOR REENTRY. Designated School the new school. The designated school official will then report the trans-
>fc-ials may endorse page 4 of the Form 1-20 A-B for reentry if the stu- fer to the Immigration and Naturalization Service.
k and/or the F-2 dependents is to leave the United Slates temporarily.
6. EXTENSION OF STAY. If you cannot complete the educational pro-
D should be done only when the information on the Form 1-20 remains
gram after having been in student status for longer than the anticipated
indianged. If there have been substantial changes in item 4,5.7, or 8.
length of the program plus a grace period in a single educational level,
i DPW Form 1-20 A-B should be issued.
or for more than eight consecutive years, you must apply for extension
!. EPORTING REQUIREMENT. Designated school official should of stay. An application for extension of stay on a Form I-538 should be
it. _ys forward the top page of the Form 1-20 A-B to the INS data proces- filed with the Immigration and Naturalization Service district office hav-
.ing center at P.O. Box 140. London, Kentucky 40741 for data entry ing jurisdiction over your school at least 125 days but no more than 60
:y~pt when the form is issued to an F-1 student for initial entry or reen- days before the expiration of your authorized stay.
0 ito the United States, or for reinstatement of student status.
7. EMPLOYMENT. As an F-1 student, you are not permitted to work off-
R uests for reinstatement should be sent to the Immigration and
campus or to engage in business without specific employment authori-
JaturaQzation Service district office having jurisdiction over the student's
zation. After your first year in F-1 student status, you may apply for
smeorary residence in this country.)
employment authorization on Form 1-538 based on financial needs aris-
1 INS data processing center will return this top page to the issu- ing after receiving student status, or the need to obtain practical training.
n ichool for disposal after data entry and microfilming.
8. Notice of Address. If you move, you must submit a notice within 10
>. CERTIFICATION. Designated school officials should certify on the days of the change of address to the Immigration and Naturalization Ser-
c"-fn part of page 1 of this form that the Form I-20 A-B is completed vice. (Form AR-11 is available at any INS office.)
in ssued in accordance with the pertinent regulations. The designated
9. Arrival/Departure. When you leave the United States, you must sur-
c o( official should remove the carbon sheet from the completed and
render your Form I-94 Departure Record. Please see the back side of
igned Form 1-20 A-B before forwarding it to the studenL
Form I-94 for detailed instructions. You do not have to turn in the I-94 if
i. ' "EMISSION RECORDS. Since the Immigration and Naturalization you are visiting Canada, Mexico, or adjacent islands other than Cuba for
'•€ ce may request information concerning the student's immigration less than 30 days.
U -_s for various reasons, designated school officials should retain all
10. Financial Support You must demonstrate that you are financially
vkJence which shows the scholastic ability and financial status on
able to support yourself for the entire period of stay in the United States
ft1'"-*! admission was based, until the school has reported the student's
while pursuing a full course of study. You are required to attach
Ji nation of studies to the Immigration and Naturalization Service.
documentary evidence of means of support.
11. Authorization to Release Information by School. To comply with
INSTRUCTIONS TO STUDENTS requests from the United States Immigration & Naturalization Service for
udent Certification. You should read everything on this page care- information concerning your immigration status, you are required to give
Jl and be sure that you understand-the terms and conditions concenv authorization to the named school to release such'information from your
HJ your admission and stay in the United States as a nonimmigrant stu- records. The school will provide the Service your name, country of birth,
ent before you sign the student certification on the bottom part of page current address, and any other information on a regular basis or upon
e law provides severe penalties for knowingly and willfully falsify- request.
> >r concealing a material fact, or using any false document in the 12. Penalty. To maintain your nonimmigrant student status, you must be
ubmlsslon of this form. enrolled as a full-time student at the school you are authorized to attend.
'- ADMISSION. A nonimmigrant student may be admitted for duration of You may engage in employment only when you have received permis-
t: s. This means that you are authorized to stay in the United States for sion to work. Failure to comply with these regulations will resutt in the
i< ntire length of time during which you are enrolled as a full-time stu- loss of your student status and subject you to deportation.
'ublic Reporting Burden. Reporting burden for this collection of information is estimated to average 30 minutes per
e onse. If you have comments regarding the accuracy of this estimate, or suggestions for simplifying this form, you
s write to both the U.S. Department of Justice, Immigration and Naturalization Service (Room 5304). Washington,
>-U, 20536; and to the Office of Management and Budget, Paperwork Reduction Project: OMB No. 1115-0051;
Vashington, D.C. 20503. _,
—ZD—
j. Department of Justice Certificate of Eligibility for Nonimmigrant (F-1) Student OMB No. 1115-0051
/nmigration and Naturalization Service Status - For Academic and Language Students
Please Read Instructions on Page 2 Page 3
This page must be completed and signed in the U.S. by a designated school official.
A. Level of education the student is pursuing or will pursue in the United States: 8. This school has information showing the following as the student's means of
(check only one) support estimated for an academic term of 9 months (Use the same
number of months given in item 7).
a. Q Primary e. Q Master's
a. Student's personal funds J 0.00
b. |~"| Secondary J. Q Doctorate
b. Funds from this school S 0.00
c. [~1 Associate g. [ | Language training
(specify type)
4 7 Bachelor's h. Other
c. Funds from another source S 18,840.00
5. The student named above has been accepted for a full course of study at
(specify type and source)
this school, majoring in Comp . Science t Eng . Tech .
d. Orvcampus employment (if any) $ 0.00
The student is expected to report to the school not later than (dale)
05/14/2001 and complete studies not later than (date) 12/31/2005 Total J 18,840.00
1JJ__Scl»ol Certification: I jwtfy under penalty of perjury that al nfomwtion provided above in Hems 1 through 8 was completed before I signed this form and 'a true and correct; I executed this
9 United/States kfter review and evaluation in the United States by me or other officials of the school of the students application, transcripts or other records of course* taken
I of taarfcial rcsponstoaty. which were received at the school prior to the execution of this form: the school has determined that the above named student's ouaSfications meet al
s for edfnission lovjfe scjioor, the student win be reouired to pursue • h* course of study as defined by B cm 21«(rx6); I am a ctesionaled official rt the above ramed school
11. Student CertiTcaliorc I have read and agreed to comply with the terms and conditions of my admission and (hose of any extension of slay as specified on page 2. I certify that all Wotmation
provided on this form refers specifically to me and is true and corred to the best of my knowledge. I certify that I seek to enter or remain in the United States temporarily, and solely for
the purpose of pursuing a fun course of study at the school named on Page 1 of this form. I also authorize the named school to release any information from my records which is needed
by the INS pursuant to 8 CFR 214.3(g) to determine my nonimmigrant status.
ingnature ol parent or guardian Nam* o< parent guardian (prmt or type) Addressjaty) (Slate or provnce) (CounUy) (Date)
il student is under 18
For official use only
McraTitm Index Number
form L2O A-an-2OK) (Rev O4-27-M)N
Page
(^3 MORE INFORMATION CONCERNING YOUR F-1 NONIMMIGRANT STUDENT STATUS AND THE RELATING IMMIGRATION PROCEDURES, PLEASE
WHEN PROPERLY ENDORSED, MAY BE USED FOR ENTRY OF THE SPOUSE AND CHILDREN OF AN F-1 STUDENT FOLLOWING TO JOIN THE STUDENT
••r-r 'ftrmrf a ttie student and/or the F-2 dependents (EACH CERTIFICATION SIGNATURE IS VALID FOR ONLY ONE YEAR.)
i^natune-a jBagnaled School Offiaal Name of School Official (port or type) Title Date
>« UJTP-* .j&gnated School Offtoal Name of School Official (onnt or type) Tale Date
ir i*e=s ^signaled School Official Name of School Official (print or type) Trtte Dale
.^rwiur^rs .-signaled School Official Name of School Official (pnnt or type) Title Date
ionaUx»r>3i je-gnaied School Offioal Name o( Scnool Official (prnt or type) TKte Dale
and children of the F-1 student who are seeking entry/reentry to the U.S.
1; e -Sri* (caps) first Date of birth Country of birth Relationship to the F-1 student
-25-
ASSURE THAT IMPRESSIONS ON APPROVED OMB 3116-000« EXP. 01/31/2OOO
J HOT STWL£ THtS FOflM ALL COPIES ARE CLEAR . 'Estimated Burden Hours: ISmins. (S«e page 4).
r\i QI i \\^j i '. on tH t^f wt^i v iw& j \w/*sJi i ipa i ijr , ^ w ^ ^ * i , L_I_/\^^J K_>WULI i, i i\/o ji^/t i, i *»^w > < v >s\j
rill be spo r r *4 oo 10
tn nanjppafP in Pw-harvje VtfiTn«- PTfVIr!»m W O « »-' » -' . '. whirh k <rttll valtH anrf fcc offirialry ftesrrib^ as fnllnws-
v program of Aramco Trail
ducation, social science...(TRC); management, business, commerce...(TRD); health related occupations (TRE); aviation (TRF);
tne sciences, engineering, architecture...(TRG); construction and building trades (TRH); and law (TRJ) for a period up to
eighteen months in the interest of international exchange.
is form covers the period from t it i i rto i i i i t i Exchange Visitors are permrrted to travel abroad & maintain status (e.g. obtain
(Ho.) (DcrjrJ (Yr.f (Ho.) (Dor) (Yr.)
a new visa) under duration of the program as indicated by the dates on this torm.
« category of this visitor is 1 ( ) Student, 2V-) Trainee, 3 ( )Teachef,4{ ) Professor, 5 ( ) International Visitor, 6 ( ) Alien Physician, 7 ( ) Govem-
mt Visitor, 6 ( ) ResejQJh^choUr, 9 ( ) Short-Term Scholar, 10 ( ) Specialist, 11 ( ) Camp Counselor. The specific field of study, research, training
or professional activity is verbally described as: Petrography analysis, sem, e-ray diffraction & forensic engr.
{Sobj/RekJ Code)
12 (. ) Summer Travel/Work
ring trie period covered bv this torm. the total estimated financial support firyU.S-1) Jis.to be provided to the exchange visitor bv:
^— . OU,UvU.uU
a. T") The Program Sponsor in Item 2 above $
s Program Sponsor has I I has not I I (check one) received funding tor international exchange from one or more U.S. Government
i 'jncyfies) to support this exchange visitor. If any U.S. Government AgencyOes) provided funding, indicate the Agencyfies) by code below.
Financial support from organizations other Than the sponsor will be provided bv one or more of the following:
> ( ) U.S. Government Agency(ies): (Agency Code). $ ; b2. (Agency Code), $
> ( ) International Organizations): (Intt Org. Code). $ ; c2 (Infl. Org. Code). *
d. ( ) The Exchange Visitor's Government . $ (If necessary, use above spaces
for funding by multiple U.S.
e. ( ) The binattonal Commission of the visitor's Country $
Agencies or InH Organizations)
I ( ) Al other organizations providing support J
fc. ( ) Personal funds $
(Address cf.RtsporuJbir.Qfficfror~AhrfT>alt-R.O.)
wiH be sponsored hy , ,„
tn parlJranatf* in Fxrhan/j* Vic'rfX ProOr^lT' No 1 ;-* '-1 '. which is still valid and is nHirtalty rH*<u-riKAfl B< follows-
A program of Arsmco Tratnino Services Company to bring to th« Unh*<3 States qualified foreign trairi«>e£ in the fields of
education, social sc>ence...(TRC); msnspement. business. cofnm«rct...(TRD); h*»tth nelaled ocxupatlons (TRE); eviarHon (TRF);
the sciences, engineerine, srchitecturB...(TRG); construction and biakJing trade* (TRH); and Isw (TRJ) for e period up to
eigtiieen months in the interest of intemetkxial exchange.
Tiis form covers the period from i i i i i i to i i i I I i Exchange Visitors are permitted to travel abroad & maintain status (e.g. obtain
(Mo.) (Day) ftr.) (Mo.) (Day) (Yr.)
i new visa) under duration of the program as indicated-by Ihe dates on this form.
rhe category of this visitor is 1 ( ) Student, 3"f> ) Train**, 3 ( ) Te»ch«r, 4 ( ) Prpf^gsor, 5/'( ) International Visitor, 6 ( ) Alien Physician, 7 ( ) Govem-
iwnt .Vlsftof, 8 ( ) Rei^ajcb.Scholar, 9 ( ' ) Short-Term Scholar, 10 ( ) Sptciatet, 1 tt;) Camp Counselor. The specific field of study, research, training
x professional activity is verbally described as: Petrography arwryws. s«m, e-ray diffraction & for*ns4C enor.
(Subj/Field Code) X *j~
12 ( ) Summer Travel/Work
Hiring the period covered bvthis form, the total estimated financial support fin US Si is to be provided to the exchange visitor by.
a. 'f- ) The Program Sponsor in Item 2 above $____! ~"
"Tws Program Sponsor has I I hasnol/T_| (check one) received funding lor international exchange from one or more U.S. Government
flencyfies) to support this exchange visitor. It any U.S. Government Agency(ies) provided landing, indicate the Agency(ies) by code betow.
Financial support from organizations other than the sponsor will be provider] bv'one'or more of the following: ' .
b1. ( ) US. Government AQencyfies): (Agency Code), $_I ; b2. (Agency Code). $_
I. ( ) international Oroanization(s): (Int. Org. Code). $ ; c2. (Infl. Org. Code). $_
„ ( ) The Exchange Visitor's Government . .._: $ (If necessary, use above spaces
for funding by multiple U.S.
e. ( ) The binational Commission of the visitor's Country $.
Agencies or Infl. Organizations)
( ) AH other organizations providing support ' $.
. ( ) Personal funds $.
(1-97) PAGE 3
Copy 3 - To be retained by Exchange Visitor
INSTRUCTIONS FOR AND CERTIFICATION BY THE ALIEN BENEFICIARY NAMED ON PAGE 1 OF THIS FORM:
Read and complete this page prior to presentation to a United Stales Consular or Immigration OHicial.
The signature of the Responsible Officer (2) Exchange Visitor is in good standing to
or the Alternate Responsible Officer on this
copy is valid for up to one year or until the
end date in item 3 on the front side of Signature of Responsible Officer Date
this Form, or to the validation date
authorized by the Responsible Officer,
(3) Exchange Visitor is in good standing to
whichever occurs sooner.
REF.NO. 002/2001
DATE. 17.04.2001
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J.S. Department of Justice
Immigration and Naturalization Service Notice of Action
ef^a&r^fgi^^S^^^^^^ajsaf^,
The above petition and extension cf stay have been approved- The .status of the named foreign worker f s) in t.hi s
classification is valid as indicated above. The foreign worker (s>* can work for the petitioner, tut only as derailed in
Lr.e iWt-J cior. cur. tor trie period dUL.iorix.ed. Any chai.oe'-rii^-ninic-yTOevu. L^^ulic;- a new ^ci_iLj.c:i. ii.ic.i: t_iil^ ti».pi.oru-.tric
authorization stems from the filing of this petition.. \Sfc£^£.tC_*employment authorization document-.*! ion is not required.
Please contact the -If.S with any questions about *;ax w
The petitioner should keep the upper portion of this notice. . The;'"tower portion should be giver, to the worker. He or
she should keep the right part with his or her Fortr. I • ?4, Afrival'Departure Record. This should be turr.ed in with the
1-94 vhen departing the U.S. The l e f t part is for his or her records. A person granted an extension of stay who leaves
the C.S. must nox-mally obtain a new visa before returning'^^Tbet^left part can be used in applying for the new visa. If
a ' v i s a " i s not required, he or-she should present it, along witnAany other required documentation, when applying for
reer.try ii: n: this
tnis nev- classir
classification
ication at a port of
or entry oS'-pre-flaJgbt
or,» -pre- ingot inspection
inspect station. The petitioner may also f i l e
Fora I - E 2 1 . ApolicBlion for Action on an Approved Applicatiqn"of petition, -..-itn thi o f f i c e to request that we n o t i f y £
consulate, port ct encry. or pre-f light .inspection o£-f.ice^T;:-iihiv> approval.
CO
'
. .
TJiiS r I A MDR MAY IT 2E ' U3ET 1H PIACS^J
Please see the additional information on the back. You will be notified separately about any other cases you filed.
IMMIGRATION-'& NATURALIZATION SERVICE ' .
.CALIFORNIA SERVICE CENTER
Pi O'. BOX.30111-' . .
.-li^OTKA NJ.^JE1.;" CA. 92^0*7-0111.
Customer Service Telephone: (949) 831 8427
F6rmI797A (Rev. 09/07/93)N
:-..EASE TSAR OFF FORM J-9J PRlhTTED 3ELCW. AND STAPtE TO ORIGINAL i-WJ AVAILABLE
Dear Dr. .:
Pursuant to your request, we have reviewed the medical report of the referenced patient,
and have scheduled the following appointment:
Patient
Appt. : April 19,2001
Time : 9:00 a.m.
Place : Center for International Delations - Mather Pavilion 1154
Physician
Dcpt. : Department of Poiiatric Cardiology
I will await your confirmation with the patient's arrival information. Please have the
patient bring any past medical reports, x-rays, of pathology slides -with them. 1 may
be reached at 21 6/844-5657 or by fax at 216^844-7535. it" you have any questions.
Sincerely yours.
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SAUDI ARABIAN OIL COMPANY
(SAUDI ARAMCO)
Social Insurance & Retirement Affairs Division
Room 212, West Park-3, Dhahran 31311, Saudi Arabia
Phone: 874-S438 • Fax: 874-8598
April 1, 2001
Employ # ..
His Excellency
The Consul General
United States Embassy
Riyadh
Your Excellency:
The above mentioned patient is a Saudi Aramco employee No # 242210 scheduled to depart
from Dammam to Houston ,USA on April 8 ,2001 for medical treatment. Patient will be
travelling with his brother Mr Turki M. M.
All costs related to medical, living and lodging expenses will be borne by Saudi Aramco.
Patient & escort will hold round-trip air rickets prior to their departure.
, Administrator
SOC. INS. & RET. AFFAIRS DFV.
AAA/ V \: Employee
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SAUDI ARAMCO
SURGICAL SERVICES DIVISION
RMA-420,BOX76
DHAHRAN 31311, SAUDI ARABIA
STEL: 8_77-8i37/8/9, FAX: 877-3695
March B, 2001
MEDICAL SUAfMAR Y
£242210. MR 40-92-47
Chief Complaint/Present Illness: Massive burns 50% total body surface area. This 43 year old
male employee was involved in a fire explosion while filing up a gasoline tanker. This patient
suffered deep bums to face, neck, both hands and the lower extremities. The explosion occurred
in a n open space with no other associated injuries. The patient arrived to our emergency room
in less than one hour post trauma.
Functional inquiry revealed that he is a smoker of one packet a day for many years. His family
history is non'Contributory except that he is an non'Sickler, he Is not G6PD deficient. The
patient has no allergies.
Physical Examination: Examination on admission revealed a young male, distressed with what
appears to be deep thermal burns to the face including the lips, nostrils, eyelids opacification of
the corneas of about Irnrq in a transverse streak fashion. The areas of scalp and neck were all
involved. Other burned areas involved the fingers on the left side, the entire hand vblar and
dorsal aspect on the right side. There was also relatively superficial bums involving the lower
extremities from the ankle all the way to th^. inguinal area bilaterally. Genitalia was spared.
Examination of the chest revealed good air entry and there was no evidence of bums over the
chest or abdomen. Heart sounds normal, no murmurs. Abdomen is soft, protuberant and no
palpable masses or palpable organs.
Laboratory Data: Initial investigations included CBC, electrolytes, BUN, creatinine were all
wirhin normal limits. Chest X-ray was negative.
Hospital Course: Two large bore IV's were started and the resuscitation commenced utilizing
the Parkland formula 4cc/kg/perccntage body surface area bum. Due to the involvement of the
face and the anticipating edema he was intubated, central line was placed. The first 24 hour
resuscitation went on smoothly and a satisfactory urine output and vital signs stable. The
wounds were cared for.
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Initially lie -was taken to the Hubbard taken on arrival. His wounds were debrided, disinfected
and covered with Sulfra Tulle dressing. His face was covered with Bacitracin including the ears
and the scalp after staving. He continued to Lave daily Hubbard tank dcbridemcnt change.
Conservative wound care to Ida burned face laid neck. "Heven days post idirdMlon, ic WB«
necessary to proceed with, first ttsgc dckridtaent. Bothhauii were debridcd, coverage to th*
right hand wfts done. Trftchcostoraywaip«Fo£m4d« the sime time. Of ilgnlficaftce; tnifeUHy lw
required tsdurotorny of tight hand tnd oU diglta. Due to &e lUperScial nature of the bum of
lower cXDrefflides, tn escharotomy w*s not ncccjstry for them. Surgically nc required four
operative trips where the burned areas were covered in stages. From first week he remained
febrile throughout until he was completely covered. He was on antibiotics intravenously with
specific type according to culture and sensitivities.
He was followed closely by the physiotherapy service from the second day post admission and
by the dietary service. Nutritional support was supplemented by total paxcnteral nutrition
initially. He could riot handle NG tube feedings. He was seen Initially by the Ophthalmology
Sfctvke and followed by thtffl eleidVr Ths e^ieiifei el Us comew corrected nicely *nd they
Were eosapltcely goni by tKe 6c&3ha wdilc pois id^lien. Tk* s&eK«ostorny tube wu removed
on Febniary 3.2001 almost one month post admission. Gradually, his condition improved he
was mobilizing nicely. On discharge, all his wounds have been closed nicely, but a small area
kept on breaking down over the scalp area. Despite the aggressive early physiotherapy, the
patient continued to have restrictive hand movement
Cpndition on Pischaigg: He was discharged home with the following problems that require
further close monitoring and out-patient therapy;
1) Early Ectropion of the lower eyelids and tearing but this was not complicated
with any conjunctivitis.
2) The restrictive movements of his hands.
3) The narrowing of the oral aperture. He has started wearing a special splint to
open the oral commissures. He was measured for special job garments.
Recommendations:
3) He is to resume normal diet as the same diet as he was taking two weeks before
he was discharged.
Actlvity. He was advised to work his hands and to try and put his fingers in the normal range of
movement and to use his hands as much as he can and to continue to apply the oral commissure
splint as needed.
Discharge Diagnosis; Massive burns 50% over body surface area with no significant
inhalation injury.
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Operations/Procedure: 1) 1/7/01, he underwent a tracheostomy and right hand
coverage.
2) On 1/23/01, he had left hand coverage in addition to
forehead an eyelid, thick split thickness skin graft
coverage.
3) On 1/31/01, he had the ears and the open areas around the
ankles covered.
4) On 2/13/01, open areas over the scalp were covered.
Complications:
_ _ Bilateral Ectropion
. • Ankylosis of right hand and less of the left hand.
Narrowing of die oral aperture.
Facial scarring which is difficult to predict its extent at this stage.
Frequent skin breakage of healed scilp With small area, of scalp
necrosis over occiput.
This patient is being referred for second opinion and further management.
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:£,.
Consul
Embassy of the United States of America
Riyadh, Saudi Arabia
I am writing to request your kind consideration to the visa application of Ms. Reem Black
and her father, Mr. John Black. Ms. Black will be undergoing medical treatment in the
United Staes under the sponsorship of the Medical Services Section, Armed Forces
Office of the Royal Embassy of Saudi Arabia.
Sincerely,
Joe Smith
Director, Medical Services Section
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U.S. VISA EXPRESS COORDINATOR
AT U.S. EMBASSY/US CONSULATE
CONTACT INFORMATION
Phone:
01-488-3800 ext. 1116 or 1129
Fax: 01-488-7275
Shayna Steinger
Vice Consul
NIV Section
AC£ TRAVEL
A L T A V Y A K TRAVEL
ATTAR TRAVEL
Ft'RSAN TRAVEL
KANOO HOLIDAYS
MINHALTRAVEL
MV.V
Tex..-t