Form I-515A Notice to Student or Exchange Visitor

Department of Homeland Security OMB N0. 1615-0083; Expires 10/31/06

U.S. Immigration and Customs Enforcement I-515A, Notice to Student or Exchange Visitor

To be completed at the port-of-entry at the time of admission: Name: _______________________________________________________________________________ Last (family) First Middle Initial Country of Citizenship: ___________________________ Date of Birth: __________________________ mm /dd / yyyy FINS #: _________________________________ SEVIS #: N____________________________________ Form I-94 (Arrival/Departure Record) #: ____________________________________________________

THIS FORM INVALID WITHOUT INSPECTOR STAMP Admission stamp with classification and date of authorized stay

NOTICE: Your admission to the United States is limited to 30 days. At your arrival, you did not present required documents. Submit the requested documents immediately (see INSTRUCTIONS, page 2). If these documents are not received within 30 days of your entry into the United States, you will not be in legal status and must leave.

F or M Visa Holders:

Y ou are an F-1/M-1 student applying for initial entry to the United States and are not in possession of a valid Form I-20 (Certificate of Eligibility for Nonimmigrant Student Status) endorsed by the school to which you are destined. Submit:

1. your original Form I-20 endorsed by the designated school official

2. your original Form I-94

3. this Form I-515A

Y ou are a returning F-1/M-1 student and are not in possession of an updated Form I-20 confirming that you are still enrolled in a U.S. school approved by the Department of Homeland Security. Submit:

1. your original updated Form I-20 endorsed by the designated school official

2. your original Form I-94

3. this Form I-515A

Y ou are an F-2/M-2 dependent either traveling with or joining a spouse/parent who entered the United States as an F-1/M-1 student. You are not in possession of required documents. Submit:

1. a photocopy of your F-1/M-1 spouse/parent’s original Form I-20 endorsed by the designated school official

2. a photocopy of your F-1/M-1 spouse/parent’s Form I-94

3. your original Form I-94

4. your original Form I-20

5. this Form I-515A.

If more than one F-2/M-2 dependent of an individual F-1/M-1 is required to submit documents, enclose all documents in a single package. Each Form I-515A must be included. A consolidated package eases handling and speeds return of documents.

J Visa Holders:

Y ou are a J-1 exchange visitor and are not in possession of a Form DS-2019 (Certificate of Eligibility for Exchange Visitors) executed by the sponsor of the exchange program to which you are enrolled or registered. Submit:

1. your original DS-2019 endorsed in BLUE ink by the program sponsor

2. your original Form I-94

3. this Form I-515A

Y ou are a J-2 dependent either traveling with or joining a spouse/parent who entered the United States as a J-1 exchange visitor. You are not in possession of required documents. Submit:

1. a photocopy of your spouse/parent’s original DS-2019 endorsed by the program sponsor

2. a photocopy of your spouse/parent’s Form I-94

3. your original Form I-94

4. your original Form I-20

5. this Form I-515A

If more than one J-2 dependent of an individual J-1 is required to submit documents, enclose all documents in a single package. This will ease handling and quicker return of documents.

Page 1 of 2 Form I-515A (rev. 03/31/2006)N

INSTRUCTIONS

You must immediately provide the requested documents identified in the selected box on page 1 of this form. Submit documents to:

Student and Exchange Visitor Program (SEVP)

Attn. Form I-515 Processing Team

Chester Arthur Building

425 I Street NW, Suite 6034

Washington, D.C. 20536

Timely submission is essential so a decision about your continued presence in the United States can be reached before the 30-day time period of this temporary admission expires. Do not send any materials that have not been requested, particularly your passport. Please only provide original documents where specified. Your documents will be returned to your designated school official or program sponsor. Failure to provide all requested documents will delay processing.

If you have questions about this submission, contact your designated school official or exchange visitor program sponsor.

Only Forms I-20 or DS-2019 created through the Student and Exchange Visitor Information System (SEVIS) and sent or given to you by your designated school official or exchange visitor program sponsor are valid.

Burden Statement – An agency may not conduct or sponsor an information collection and a person is not required to respond to an information collection unless it contains a currently valid OMB approval number. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the U.S. Citizenship and Immigration Services, Regulatory Management Division, 111 Massachusetts Avenue NW, Washington, DC 20529, OMB NO. 1615-0083. DO NOT submit this form and requested supporting documents to this address, but to the address in the INSTRUCTIONS (above).

Page 2 of 2 Form I-515A Instructions (rev. 03/31/2006)N