Form I-515A Notice to Student or Exchange Visitor

OMB N0. 1653-0037

Department of Homeland Security Expires 10/31/2009

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 Name) (First Name) (Middle Name) Country of Citizenship: _______________________________________ DOB: ____________________ FINS Number: _______________________________ SEVIS ID Number: _______________________ Admission Number: ____________________________________________________________________ U.S. Address: _________________________________________________________________________ (Street Number and Name) (Apt. Number) ___________________________________________________________________________________________ (City) (State) (Zip Code) Telephone Number: ____________________________________

Admission stamp with classification and date of authorized stay

Your admission is limited to 30 days because you lack the required documentation.

Submit the requested documents checked. DO NOT SEND PASSPORT.

Y ou are an F-1/M-1 student applying for initial entry to the United States not in possession of a valid Form I-20, Certificate of Eligibility for Nonimmigrant Student, endorsed by the school to which you are destined. Within the next 30 days, the designated official of the school to which you are destined must complete and certify the Form I-20. Submit all of the following documents to the address listed on page 2.

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

2. Your original Form I-94, Arrival-Departure Record; and

3. This completed Form I-515A.

Y ou are an F-1/M-1 student applying for entry to the United States not in possession of evidence of the I-901 SEVIS fee payment. Within the next 30 days, you must pay the fee via the Internet at www.FMJfee.com. Submit all of the following documents to the address listed on page 2.

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

2. Your original Form I-94, Arrival-Departure Record;

3. Your Form I-797 fee receipt; and

4. This completed Form I-515A.

Y ou are a returning F-1/M-1 student not in possession of an updated Form I-20 confirming that you are still enrolled in a U.S. school certified by DHS to enroll F-1 and/or M-1 students. Within the next 30 days, the designated official of the school which you are attending must update the Form I-20. Submit all of the following documents to the address listed on page 2.

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

2. Your original Form I-94, Arrival-Departure Record; and

3. This completed Form I-515A.

Y ou are a J-1 exchange visitor not in possession of a Department of State (DoS) Form DS-2019, Certificate of Eligibility for Exchange Visitors, executed by the sponsor of the exchange program to which you are enrolled or registered. Within the next 30 days, the sponsor must complete the DoS Form DS-2019. Submit all of the following documents to the address listed on page 2.

1. Your original DoS Form DS-2019 endorsed in BLUE ink by the program sponsor;

2. Your original Form I-94, Arrival-Departure Record; and

3. This completed Form I-515A.

Y ou are being accompanied by your spouse and/or child(ren) at the time of entry. You should submit their original Form I-94, Arrival-Departure Record, and their Form I-20 or DoS Form DS-2019 to the address listed on page 2.

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Y ou are an F-2/M-2 dependent joining a spouse/parent who is a student in the United States, but are not in possession of the required documents. Within the next 30 days, you must submit all of the documents to the address listed below.

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

2. A photocopy of your spouse’s/parent’s Form I-94, Arrival-Departure Record, verifying your spouse’s/parent’s admission into the United States;

3. Your original Form I-94, Arrival-Departure Record;

4. Your original Form I-20; and

5. This completed Form I-515A.

Y ou are a J-2 dependent joining a spouse/parent who is an exchange visitor in the United States, but are not in possession of the required documents. Within the next 30 days, you must submit all of the documents to the address listed below.

1. A photocopy of your spouse’s/parent’s original DoS Form DS-2019 endorsed by the program sponsor;

2. A photocopy of your spouse’s/parent’s Form I-94, Arrival-Departure Record, verifying your spouse’s/parent’s admission into the United States;

3. Your original Form I-94, Arrival-Departure Record;

4. Your original DoS Form DS-2019; and

5. This completed Form I-515A.

O ther:

NOTE: DO NOT SEND PASSPORT. Failure to provide all of the documents requested, particularly the original documents, will result in a delay in the processing of your application. All documents will be returned to the designated school official or program sponsor.

Student and Exchange Visitor Program

SEVIS/I-515A Processing Team

Potomac Center North

500 12^th Street SW

Washington, DC 20536

Privacy Statement

Authority and Purpose: Sections 1101 and 1184 of Title 8, U.S. Code authorize ICE to collect this information. This collection of information is used to ensure that students, exchange visitors, or dependents who are otherwise eligible to be admitted into the United States are not prevented from entering because they do not have the proper documentation in their possession.

Disclosure: Furnishing your information is voluntary; however, failure to provide it may result in denial of admission to the United States.

Routine Uses: Your information may be disclosed to the Department of State for purposes related to the issuance or denial of visas and for the administration of the exchange visitor program.

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 Office of Management and Budget (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 Department of Homeland Security, U.S. Immigration and Customs Enforcement, 500 12^th Street SW, Room 3138, Washington, D.C. 20536, OMB No. 1653-0037.

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