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1.94 when I entered as a nonimmigrant member of the military, and I am filing this application for an initial Form 1-94. 4. Class of Admission at Last Entry into the United States E2 5. Place of Last Entry into the United States (City and State) NEW "PAsspoet ciplizpv-“ow. LDS ANhel-6,5 Form 1-102
ant's Contact Information 4. Applicant's Daytime Telephone Number 5. Applicant's Mobile Telephone Number 6. Applicant's E-mail Address Part 5. Contact Information, Certification, and Signature of the Interpreter Interpreter's Full Name Provide the following information concerning the interpreter: l.a. Interpreter's Family
it appears on Form 1-94, I-94W, or I-95. 3.a. Family Name (Last Name) 3.b. Given Name (First Name) 3.c. Middle Name 4. Class of Admission at Last Entry into the United States E2 5. Place of Last En into the United States City and State) Form 1-102 10/19/17 N Page 2 of 4 EFTA01731225 Part 4.
Signature (mmiddiyyyy) ► Applicant's Contact Information 4. a Number 5. A limes Mobile Tel hone Number 6. A licant's E-mail Address Part 5. Contact Information, Certification, and Signature of the Interpreter Interpreter's Full Name Provide the following information concerning the interpreter: 1.a. Interpreter's Family
it appears on Form 1-94, I-94W, or I-95. 3.a. Family Name (Last Name) 3.b. Given Name (First Name) 3.c. Middle Name 4. Class of Admission at Last Entry into the United States E2 5. Place of Last En into the United States City and State) Form 1-102 10/19/17 N Page 2 of 4 EFTA01684010 Part 4.
Signature (mm/dd/yyyy) ► Applicant's Contact Information 4. a Number 5. A limes Mobile Tel hone Number 6. A licant's E-mail Address Part 5. Contact Information, Certification, and Signature of the Interpreter Interpreter's Full Name Provide the following information concerning the interpreter: 1.a. Interpreter's Family
I-94 when I entered as a nonimmigrant member of the military, and I am filing this application for an initial Form I-94. 4. Class of Admission at Last Entry into the United States E 5. Place of Last Entry into the United States (City and State) OartJ: :Pro- cessing Information . La. Are you filing th
tforingthit 4. Interpreter's Daytime Telephone Number 5. Interpreter's E-mail Address Fox= I-102 10/19/17 N Page 3 of 4 EFTA01699765 Part 5. Contact Information, Certification, and Signature of the Interpreter(continued) Interpreter Certification I certify that: I am fluent in English and ,which is the same language
Entities connected to both Last Entry and Contact Information, Certification
Preparer
ORGANIZATIONNew York State Division of Criminal Justice Services
ORGANIZATIONNational Crime Information Center
ORGANIZATIONFederal, State
ORGANIZATION
Jeffrey Epstein
PERSONRequesting Law Enforcement Agency
ORGANIZATION
Homeland Security
ORGANIZATIONAlbany
LOCATIONParole and Law Enforcement Programs Unit
ORGANIZATIONMonitoring Case
ORGANIZATION
Department of Homeland Security
ORGANIZATIONthe Social Security Administration
ORGANIZATIONNew York Field Office
LOCATION
Michael C.Green
PERSONthe NYS Division of Criminal Justice Services
ORGANIZATIONMonitoring Group
ORGANIZATIONU.S. Immigration and Customs Enforcement
ORGANIZATIONFederal Bureau of Investigation - New York
ORGANIZATIONBoard of Immigration Appeals
ORGANIZATIONOffice of Refugee Resettlement
ORGANIZATION