Form 1650-02 Visitor Notification

OMB Number: 3064-0222
Expiration Date: 06/30/2028

Federal Deposit Insurance Corporation

FOREIGN NATIONAL VISITOR NOTIFICATION
INSTRUCTIONS: The FDIC host sends this form to foreign nationals (and their staff, if applicable) visiting the FDIC for any reason.
The visitor completes Sections I-II of the form. The FDIC host completes section III and submits completed form to the FDIC,
Intelligence and Threat Sharing Unit (ITSU) for review.
SECTION I - FOREIGN NATIONAL VISITOR INFORMATION
1. Surname/Family Name/Last Name

2. Given Name/First Name

5. Date of Birth

4. Aliases (List All)
6. City and Country of Birth
8. Passport Country/Jurisdiction of Issue

3. Middle Name

7. City and Country of Residence
9. Passport Number

11. Email

10. Expiration Date
12. Telephone

SECTION II - EMPLOYER INFORMATION
13. Current Employer (Business/Organization Name)
14. Type of Business/Organization

15. Position Title

SECTION III - FDIC HOST INFORMATION
16. Event Host or Point-of-Contact (Federal Employee)
Name:

Title:

Email:

17. Hosting Division/Office
18. Meeting or Event Purpose
19. Meeting or Event Start and End Date(s)
SECTION IV - ITSU REVIEW
20. Is a brief to sponsoring office required?:

Yes

No

Explain.

21. Completed By

FDIC 1650/02 (10-25)

22. Date

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