DS9 Document EFTA01262325

ri 09:04 TECS II - I-94 ARRIVAL/DEPARTURE DISPLAY 030206 T2MRM203 3 1? TID= NOMZ DETAIL VIEW T2PRM209 P . ADMN REC 001 OF 001 ADMISSION/DEPARTURE NBR ADMISSION CODE H1 VALID TO 05302006 20 ,, 0 NAME (LAST, FIRST) CITIZENSHIP BY DOB GENDER F MISC 0' z r-4 PASSPORT NBR WORK 00 COUNTRY OF RESIDENCE BY i--,' ul ALIAS LN ALIAS DOB i ALIAS FN ALIAS COC a. *********** ARRIVAL INFORMATION *********** cc 0 AIRLINE AC AIR CANADA FLIGHT NBR 00736 ARRIVAL DATE 08112005 cc VISA ISSUE CITY OTTAWA VISA ISSUE DATE 08112005 PORT OF ENTRY OTT a.< U.S. ADDRESS- STREET CITY STATE M t INSPECTOR NUMBER 2465 MICROFILM NUMBER TRAVEL MODE AIR .2 L., COMMENTS STATUS CODE A of LLJ ***** DEPARTURE INFORMATION ********** PORT DEPARTURE DATE TRAVEL MODE 1= u L., CARRIER FLIGHT NBR/SHIP NAME 1 - c) cc o_ (F1/F2=HELP) (F3=MAIN MENU) (F4=HITLIST) (F9=VW ACCESS) (F16=PRINT REC) c) 1 - (F7=PRIOR PAGE) (F8=NEXT PAGE) (F10=FIRST PAGE) (F11=LAST PAGE) (F12=INQUIRY) Q.) J LLJ R 4A0 06,077 D ul i, g PROT0 FSXMIPT1 CLAIMS MAINFRAME SYSTEM 03/02/2006 PETITION UPDATE PROCESSING 09:25 MODE: L MGMCLARK FORM: 1129 RECEIPT NBR: OWNED BY: EAC PART 2: A PART 3: A RECEIVED DATE: 06/09/2003 REF NBR: APPEALED FORM: 711510 ASSOC RCPT NBR: PETITNER: NEXT MGT ATTN: FAITH KATES PRE CERT? STREET: 23 WATTS ST CITY: NEW YORK STATE: NY PROVINCE: CNTRY: ZIP/POSTAL: 10013 DOB: COB: SOC SEC NBR: A-NBR: EMPLOYER: NEXT MGT TAX ID: CONSLAT: PARIS POE: CLASS: 1B1 PREFERENCE: 1B1 NBR BENF: 1 COA: STATUS/ACTION: IBS1 NO SYSTEM IDENTIFIED DEROGATORY INFO PRIORITY DATE: DATE VALID FROM: 06112003 TO: 05302006 N t8 -a , r O z 0,- 0.6 N (r) a. 00 CD 00 a. cc LU 0 00 w U LU DC998001 UPDATE NOT ALLOWED - RECEIPT OWNED BY EAC 0 00 CL PF1 PF2 PF3 PF4 PF5 PF6 PF7 PF8 PF9 PF10 PF11 0 F- BENF CI INQ CANCEL PRV MEN EAD MAIN MEN CODES LOGOFF REMIT REPR HIST F- U 4A0 07,012 LU 00 I 00 ul PROT1 FSXMIPT6 03/02/2006 I-129 H1B BENEFICIARY CASE INFORMATION 09:25 MGMCLARK RCPT NBR: PETITNER: NEXT MGT NAME: c/o: STREET: CITY: STATE: PROVINCE: CNTRY: ZIP/POSTAL: DOB: COB: SOC SEC NBR: A-NBR: A DOA: I-94 #: EXPIRES: CONSLAT: POE: CLASS: 1B1 JOB CODE: 297 EDUCATION CODE: A COMPENSATION:$ 100,000.00 ILLEGIBLE/NOT PROVIDED? N FIELD OF STUDY: GENERAL STUDIES NAICS CODE: 711510 J-1 WAIVER? N H-1B ELIGIBLE 6 YRS? N PREVIOUS EMPLOYER EXEMPT? N DECISION: A DECISION DATE: VALID FROM: 06112003 TO: 05302006 BENEFICIARY DISPLAYED. PF2 PF4 CI INQ RETURN I4A0 07,012 N g.1 c 2 'H 0 0,, 06 N a. 00 00 a. 00 LU 0 00 w U LU 0 00 0 F- F- U LU 00 00 PROT2 FSXMIPT1 03/02/2006 PETITION UPDATE PROCESSING 09:23 MODE: L MGMCLARK FORM: 1129 RECEIPT NBR: OWNED BY: EAC PART 2: A PART 3: A RECEIVED DATE: 02/03/2003 REF NBR: APPEALED FORM: 711510 ASSOC RCPT NBR: PETITNER: KARIN MODELS ATTN: MATTHEW T CIMATO CFO PRE CERT? STREET: 6 WEST 14TH STREET 3FL CITY: NEW YORK STATE: NY PROVINCE: CNTRY: ZIP/POSTAL: 10011 DOB: COB: SOC SEC NBR: A-NBR: EMPLOYER: KARIN MODELS TAX ID: 133914333 CONSLAT: BRATISLAVA POE: CLASS: 1B3 PREFERENCE: 1B3 NBR BENF: 1 COA: STATUS/ACTION: IEA APPROVAL NOTICE SENT PRIORITY DATE: DATE VALID FROM: 04012003 TO: 01012006 DC998001 UPDATE NOT ALLOWED - RECEIPT OWNED BY EAC PF1 PF2 PF3 PF4 PF5 PF6 PF7 PF8 PF9 PF10 PF11 BENF CI INQ CANCEL PRV MEN EAD MAIN MEN CODES LOGOFF REMIT REPR HIST 4A0 07,012 N r-t •,°, c . m 2 'H Z r cp o 0,- N Ln I a. 000 < 00< a. cc LU 0 00 0 Ui F- U LU H 0 00 Cl_ 0 H H U LU 00 D 00 PROT3 FSXMIPT6 I-129 H1B BENEFICIARY CASE INFORMATION RCPT NBR: PETITNER: KARIN MODELS NAME: C/O: STREET: STATE: DOB: DOA: CONSLAT: PROVINCE: COB: MI I-94 #: 03/02/2006 09:23 MGMCLARK CITY: CNTRY: ZIP/POSTAL: SOC SEC NBR: A-NBR: A EXPIRES: POE: CLASS: 1B3 JOB CODE: 297 EDUCATION CODE: B COMPENSATION:$ FIELD OF STUDY: FASHION MODELING J-1 WAIVER? N H-1B ELIGIBLE 6 Y DECISION: A DECISION DATE: 100,000.00 ILLEGIBLE/NOT PROVIDED? N NAICS CODE: 711510 RS? N PREVIOUS EMPLOYER EXEMPT? N VALID FROM: 04012003 To: 01012006 BENEFICIARY DISPLAYED. PF2 PF4 CI INQ RETURN 4A0 07,012 N ,t3 In 2 1 z ri c9i cr) 00 N CC CD cc a CL w 0 cc 0 L>1 w cc 0 U fro' In PROT4 FSXMIPT1 03/02/2006 PETITION UPDATE PROCESSING 09:24 MODE: L MGMCLARK FORM: 1129 RECEIPT NBR: MOM= OWNED BY: EAC PART 2: E PART 3: C RECEIVED DATE: 12/06/2005 REF NBR: APPEALED FORM: 711510 ASSOC RCPT NBR: PETITNER: MC2 MODEL MGT DBA KARIN MODELS ATTN: EVE VALENZUELA ADMINISTRATOR PRE CERT? N STREET: 6 WEST 14 STREET CITY: NEW YORK STATE: NY PROVINCE: CNTRY: ZIP/POSTAL: 10011 DOB: SOC SEC NBR: COB: A-NBR: EMPLOYER: MC2 MODEL MGT DBA KARIN MODELS TAX ID: 200451953 CONSLAT: POE: CLASS: 1B3 PREFERENCE: 163 NBR BENF: 1 COA: STATUS/ACTION: IBS1 NO SYSTEM IDENTIFIED DEROGATORY INFO PRIORITY DATE: DATE VALID FROM: 12092005 TO: 11302008 DC998001 UPDATE NOT ALLOWED - RECEIPT OWNED BY EAC PF1 PF2 PF3 PF4 PF5 PF6 PF7 PF8 PF9 PF10 PF11 BENF CI INQ CANCEL PRV MEN EAD MAIN MEN CODES LOGOFF REMIT REPR HIST 4A0 07,012 5, N Lt. LI - - 0 C 0 z - cr) 00 N a. 00 00 a. 00 LU 0 00 Ui U LU 0 00 0_ 0 F- F- U L1.1 00 0 (J) PROT5 h FSXMIPT6 03/02/2006 ,Q - 0,-, I - 129 H1B BENEFICIARY CASE INFORMATION g,, c 09:24 MGMCLARK ,r, RCPT NBR: 2 ;fi c15' PETITNER: MC2 MODEL MGT DBA KARIN MODELS z ,-, o0 NAME: IM .6' C/O: r--- STREET: CITY: i STATE: PROVINCE: CNTRY: ZIP/POSTAL: a. DOB: COB: IM SOC SEC NBR: A-NBR: A cc DOA: 11202005 I-94 #: EXPIRES: 01012006 CONSLAT: POE: CLASS: 1B3 JOB CODE: 297 ta. r, EDUCATION CODE: B COMPENSATION:$ 100,000.00 ILLEGIBLE/NOT PROVIDED? N 0LL, FIELD OF STUDY: FASHION MODELING NAICS CODE: 711510 ,2 c) J-1 WAIVER? N H-1B ELIGIBLE 6 YRS? Y PREVIOUS EMPLOYER EXEMPT? N U LL, DECISION: A DECISION DATE: VALID FROM: 12092005 TO: 11302008 1 - c) 00 BENEFICIARY DISPLAYED. c,_ PF2 PF4 o 1 - CI INQ RETURN 1-u 4A0 07,012 'Ca D v - ) PROT6 N 09:04 TECS II - I-94 ARRIVAL/DEPARTURE DISPLAY 030206 T2MRM203 73 TID= NOMZ DETAIL VIEW T2PRM209 g,' c c° ADMN REC 001 OF 001 oEur) ADMISSION/DEPARTURE NBR ADMISSION CODE H1 VALID TO 01012006 2 C, o NAME (LAST, FIRST) z CITIZENSHIP DOB GENDER F 0.; PASSPORT NBR WORK oO COUNTRY OF RESIDENCE US UNITED STATES i--,' ALIAS LN ALIAS DOB iul ALIAS FN ALIAS COC a. *********** ARRIVAL INFORMATION ****** cc AIRLINE ZZ UNKOWN AIRLINE CODE FLIGHT NBR 00908 ARRIVAL DATE 11202005 VISA ISSUE CITY VISA ISSUE DATE 08042003 PORT OF ENTRY CHA U.S. ADDRESS- STREET 301 E 66TH ST CITY NEW YORK CITY STATE NY INSPECTOR NUMBER MICROFILM NUMBER TRAVEL MODE AIR a LL, COMMENTS STATUS CODE AD C) of LL, ********** DEPARTURE INFORMATION ********** PORT NYC DEPARTURE DATE 12152005 TRAVEL MODE 1= u LL, CARRIER OK CESKOSLOVENSKE A FLIGHT NBR/SHIP NAME 51 1 - c) r: (F1/F2=HELP) (F3=MAIN MENU) (F4=HITLIsT) (F9=vw ACCESS) (F16=PRINT REC) 1- c) (F7=PRIOR PAGE) (F8=NEXT PAGE) (F10=FIRST PAGE) (F11=LAST PAGE) (F12=INQUIRY) 1- Q) 4A0 LU 07,077 I ,,S ul PROT7 CIMSIN IMMIGRATION AND NATURALIZATION SERVICE 03/02/06 p.! COMMAND: CENTRAL INDEX SYSTEM - DETAILED SEARCH DISPLAY 09:13:05 co oEul A#: NAME: DOB: 0 2o z ,-i 9 op.; LAST: FIRST: NATZ DATE: 06' MIDDLE: COURT: N ALIASES: LOCATION: i a. SEX: F POE: WAS COB: . DOE: 12202004 FCO: NRC COA: CR6 COC: FTC: 02172005 FATHER: cc 0 cc PFCO: SSC SFCO: DFO: 12252002 BIN: MOTHER: c,.. cc SSN: CONSOLIDATED A-NOS --OTHER INFORMATION-- a LL, I-94 ADM #: EADS-X CARD-X VIOL-X of PASSPORT #: c) FBI #: DRIVER LIC: 1= u LL, FINGER CD#: RSWURSWURSLSLSLSWULS 1 - c) cc CLEAR EXIT PF1 NEXT CONS A# PF2 PRIOR CONS A# PF4 RETURN PF5 HELP c,_ PF6 CIS MAIN MENU PF7 NEXT SEARCH PF8 VIEW HISTORY PF9 VIEW EAD PF11 EOIR c) 1 - H. u 4A0 02,011 c7, u, PROT8 REASON/ ID NUMBER/ ACTION LOC ACTION-DATE ST COURT# MISC MISC-DATE KEYED-DATE APPREHENSION WAS 12/25/2002 I-275 00/00/0000 12/27/2002 STATUS CHANGE MIA 12/25/2002 WD 09/30/2003 STATUS CHANGE SSC 12/25/2002 B2 01/15/2005 VISA PACKET MIA 09/30/2003 PEN 09/30/2003 CLAIMS MIA 12/20/2004 CR6 1181 01/15/2005 ri CIMDHI PAGE: 0001 IMMIGRATION AND NATURALIZATION SERVICE 03/02/06 r., -0 COMMAND: CENTRAL INDEX SYSTEM - STATUS/HISTORY DATA 09:13:16 g; c ',..P. m 8 Ln" NAME: ,M DOB: 2' d ri z ri 9' icr; oe 3: v) (.9 <t of <t c,_ w w c) of o !-7.. j> P: (..) w F- O *** END OF HISTORY DISPLAY *** ea_ CLEAR EXIT PF1 PAGE AHEAD PF2 PAGE BACK PF4 RETURN PF5 HELP PF6 MAIN MENU c) E- I-- L) 4A0 04,005 U-I D ,JI PROT9 FSXMHST1 PAGE: 1 OF 1 CASE HISTORY RECEIPT DATE: 11/14/2003 ACTION CODE AA RECEIVED IAA RECEIPT NOTICE SENT DA APPROVED IEA APPROVAL NOTICE SENT MBC ADVANCE PAROLE DOCUMENT RECEIPT NUMBER: MSC-04-063-10062 03/02/2006 09:19 MGMCLARK ACTION DATE USER ID 12042003 MSCLKBOX 12042003 MSCLKBOX 01032004 MSCDLWO2 01032004 MSCDLWO2 01052004 MSCGEFO1 PRESS PF4 OR "ENTER" TO RETURN TO PREVIOUS SCREEN PF1 PF2 PF4 PF6 PF7 PF8 PF11 PG FWD PG BACK RETURN MAIN MENU CODES LOGOFF AUDIT 4A0 01,002 N g.1 c 2 z - cr) 0.6 N Li) a. 00 00 a. 00 LU 0 00 w U LU 0 00 O_ 0 F- F- U LU 00 0 vl p C ul PROT10 vi tv I FSXMERET CLAIMS/EAD MAINFRAME SYSTEM EMPLOYMENT AUTHORIZATION DOCUMENT UPDATE/INQUIRY 03/02/2006 09:19 MGMCLARK RCPT NBR: A-NBR: A REFERENCE NBR: OWNED BY: MSC RECEIVED DATE: 12/20/2004 NAME: STREET: CITY: STATE: ZIP: 1.6 PHONE: CITZSHP: IIIII COB: DOB: SEX: F MAR STAT: M SSN NBR: 194 NBR: DATE ARR: 12112004 POE: MANNER LAST ENTRY: CURRENT STATUS: ABC MEMBER: N PHOTO ATTACHED(Y/N): Y ELIGIBILITY: 274A.12( C )( 09 ) PROV CODE: MULTIPLE(Y/N): N NONE(Y/N): N (ENTER DATES AS MMDDCCYY) EMPLOYMENT START DATE: EXPIRATION DATE: NAME ON CARD: ISSUE CODE: CARD ISSUE/DENIAL DATE: OFFICER ID: DENIAL CODE: SERIAL NBR: N 7:3 C 0, L. u 2 %z ri 9' CT 00 N ol cc [repeated 3 times] w cc 0 w U DC998001 UPDATE NOT ALLOWED - RECEIPT OWNED BY MSC PF4 PF6 PF8 PF9 PF10 PF11 PF12 cc 0 PRIOR MENU MAIN MENU LOGOFF REMIT REP/ATTY STATUS PRINT CARD U 4A0 07,012 In PROT11 FSDLEREP CLAIMS/EADS MAINFRAME SYSTEM INQUIRY/UPDATE - REPRESENTATIVE DATA TYPE: A A. ATTORNEY B. ACCREDITED REPRESENTATIVE C. OTHER REP CODE: NAME: DE LEON FRM/VLAG: STREET: 561 NE 79TH STREET STE 204 RUBEN CITY: MIAMI STATE: FL PROVINCE: COUNTRY: ZIP/POSTAL CODE: 33138 L 3/02/2006 09:19 MGMCLARK DC997961 - VIEW MODE PF4 PREV SCREEN 4A0 05,012 N - 0 z N-1 0, - 0.6 N Li) a. 00 00 a. LU 0 00 w U LU 0 00 O_ 0 F- F- U w 00I ul EFTA_00250718 PROT12 tv ri I FSXMERET CLAIMS/EAD MAINFRAME SYSTEM 03/02/2006 r.-: 73 EMPLOYMENT AUTHORIZATION DOCUMENT UPDATE/INQUIRY 09:20 ,i) `u MGMCLARK o i Ll ri RCPT NBR: A-NBR: A ) d REFERENCE NBR: ri OWNED BY: MIA RECEIVED DATE: 11/15/2003 9 a; NAME: 06 STREET: N (,) CITY: STATE: ZIP: PHONE: 7: CL CITZSHP: COB: M DOB: SEX: <t MAR STAT: SSN NBR: 194 NBR: of QD DATE ARR: POE: MANNER LAST ENTRY: CURRENT STATUS: B2 I <t of ABC MEMBER: N PHOTO ATTACHED(Y/N): Y <t ELIGIBILITY: 274A.12( C )( 09 ) PROV CODE: MULTIPLE(Y/N): N NONE(Y/N): N fc w c) (ENTER DATES AS MMDDCCYY) ISSUE CODE: 1 c) of EMPLOYMENT START DATE: 11152003 CARD ISSUE/DENIAL DATE: 11152003 I I EXPIRATION DATE: 11142004 OFFICER ID: MIA2870 DENIAL CODE: F: NAME ON CARD: SERIAL NBR: (.) w F- C) DC998001 UPDATE NOT ALLOWED - RECEIPT OWNED BY MIA I a. PF4 PF6 PF8 PF9 PF10 PF11 PF12 c) F- PRIOR MENU MAIN MENU LOGOFF REMIT REP/ATTY STATUS PRINT CARD F- L) 4A0 07,012 L, 2 u, PROT13 I ' FSXMIAPS 03/02/2006 ADJUST STATUS UPDATE PROCESSING 09:20 MGMCLARK FORM NBR: 1181 RCPT NBR: REF NBR: OWNER: SRC A-NBR: APP TYPE: RECEIVED DATE: 01/04/2005 REMOTE TO: NAME: C/O: STREET: CITY: STATE: • PROVINCE: CNTRY: ZIP/POST: IIIIII DOB: COB: l l SOC SEC NBR: PRIORITY DT: 00000000 OCCUPATN: 999 MARITAL STATUS: M CURR STAT: B2 LAST ENTRY STATUS: LAST ENTRY PLACE: CARD TYPE: 1 TRANSACT CODE: 1 REASON FOR APPL: SEX: F MOTHER'S FIRST NAME: FATHER'S FIRST NAME: CLS GRNTD: CR6 CR EXPIRES: ADM/ADJ DATE: 12202004 POE: MIA AMC: I-89 EXEC LOC: MIA OTHR FNGPR: FNGPRNT WVR: N I-89 EXEC DATE: 1217 2004 SIG WAIVR: N PHOTO WVR: N VIEW SPONSORS: N VIEW ADDITIONAL I-485 INFORMATION(Y/N): N ACTION: MA CARD PRODUCED DC998001 UPDATE NOT ALLOWED - RECEIPT OWNED BY SRC PF1 PF2 PF3 PF4 PF6 PF7 PF8 PF9 PF10 PF11 CARD INFO CIS CANCEL BACK MAIN MENU CODES LOGOFF REMIT ATTY STAT HIS LIA0 20,072 N '-4 g.1 • C '4' M 2 '-' o ,C) zo- 0.6 N Ln I a. 00 CD 00< a. cc LU 0 00 0 LL IU LU I- O 00 O_ 0 I- I- U LU 00 D 00 PROT14 FSDLSPON 03/02/2006 I-864 SPONSOR INQUIRY 09:21 MGMCLARK SOC SEC NBR: NAME: ROSS III DUNCAN BAKER RESIDENCE: STREET: CITY: STATE:. PROVINCE: COUNTRY: ZIP/POSTAL: MAILING ADDRESS: STREET: CITY: STATE: PROVINCE: COUNTRY: ZIP/POSTAL: N C 0, Lu 2 c s, z ri CT 06 N ol cc cc w cc 0 DOB: U.S. CITIZEN(Y/N)? Y PRESS "ENTER" OR PF4 TO RETURN TO PREVIOUS SCREEN A-NBR: w O CC 0 PF4 PF6 PF8 PREV MENU MAIN MENU LOGOFF U 4A0 01,002 D In PROT15 ri FSDLSPON 03/02/2006 I-864 SPONSOR INQUIRY 09:21 MGMCLARK SOC SEC NBR: NAME: MCMILLION LISA LISA RESIDENCE: STREET: CITY: STATE: ROSS PROVINCE: - cr) 0,6 N In cc COUNTRY: MAILING ADDRESS: STREET: CITY: ZIP/POSTAL:111F STATE: PROVINCE: cc cc w COUNTRY: ZIP/POSTAL: DOB: U.S. CITIZEN(Y/N)? Y A-NBR: U w PRESS "ENTER" OR PF4 TO RETURN TO PREVIOUS SCREEN PF4 PF6 PF8 PREV MENU MAIN MENU LOGOFF 4A0 01,002 cc 0 U fro' PROT16 CIMSIN COMMAND: A#: IMMIGRATION AND NATURALIZATION SERVICE 03/02/06 CENTRAL INDEX SYSTEM - DETAILED SEARCH DISPLAY 09:08:45 8E,H ui r' O; LAST: 06 FIRST: NATZ DATE: MIDDLE: COURT: 3: ALIASES: LOCATION: a. cc cc 0 SSN: CONSOLIDATED A-NOS --OTHER INFORMATION-- c) I-94 ADM #: EADS-X CARD-X VIOL-X PASSPORT #: FBI #: LL DRIVER LIC: FINGER CD#: RSWURSWURSLSLSLSWULS CLEAR EXIT PF1 NEXT CONS A# PF2 PRIOR CONS A# PF4 RETURN PF5 HELP PF6 CIS MAIN MENU PF7 NEXT SEARCH PF8 VIEW HISTORY PF9 VIEW EAD PF11 EOIR 4A0 02,011 NAME: SEX: F POE: WAS FCO: NRC COA: CR6 PFCO: SSC SFCO: COB: DOE: 12202004 COC:IIIIII FTC: 02172005 FATHER: DFO: 12252002 BIN: MOTHER: DOB: PROT17 CIMDHI PAGE: 0001 IMMIGRATION AND NATURALIZATION SERVICE 03/02/06 COMMAND: CENTRAL INDEX SYSTEM - STATUS/HISTORY DATA 09:09:00 A#: NAME: DOB: REASON/ ID NUMBER/ ACTION LOC ACTION-DATE ST COURT# MISC MISC-DATE KEYED-DATE APPREHENSION WAS 12/25/2002 I-275 00/00/0000 12/27/2002 STATUS CHANGE MIA 12/25/2002 WD 09/30/2003 STATUS CHANGE SSC 12/25/2002 B2 01/15/2005 VISA PACKET MIA 09/30/2003 PEN 09/30/2003 CLAIMS MIA 12/20/2004 CR6 i181 01/15/2005 ' *** END OF HISTORY DISPLAY *** CLEAR EXIT PF1 PAGE AHEAD PF2 PAGE BACK PF4 RETURN PF5 HELP PF6 MAIN MENU h4A0 04,005 m2 N Qi 2 c s, Z - cr) 00 N In cc (.9 cc w cc 0 L>1 I- w U cc 0 U fro' In PROT18 09:03 TID= NOMZ h ,-4 TECS II - I-94 ARRIVAL/DEPARTURE DISPLAY 030206 T2MRM203 I 2 -0 DETAIL VIEW T2PRM209 g,' c c° ADMN REC 001 OF 001 0 ul ADMISSION/DEPARTURE NBR ADMISSION CODE DT VALID TO 12292005 NAME (LAST, FIRST) z CITIZENSHIP DOB GENDER F MISC 2 0 9 0,- PASSPORT NBR oO COUNTRY OF RESIDENCE US UNITED STATES r: ul ALIAS LN ALIAS DOB i ALIAS FN ALIAS COC *********** ARRIVAL INFORMATION *********** cc AIRLINE LO POLSKIE LINIE LOTNIC FLIGHT NBR 00001 ARRIVAL DATE 12302004 VISA ISSUE CITY VISA ISSUE DATE 02052003 PORT OF ENTRY CHI U.S. ADDRESS- STREET CITY STATE MI INSPECTOR NUMBER 1192 MICROFILM NUMBER TRAVEL MODE AIR a LL, COMMENTS STATUS CODE P C) cc LL, ********** DEPARTURE INFORMATION ********** PORT DEPARTURE DATE TRAVEL MODE 1=.) LL, CARRIER FLIGHT NBR/SHIP NAME 1 - C) cc cL (F1/F2=HELP) (F3=MAIN MENU) (F4=HITLIST) (F9=VW ACCESS) (F16=PRINT REC) C) 1- (F7=PRIOR PAGE) (F8=NEXT PAGE) (F10=FIRST PAGE) (F11=LAST PAGE) (F12=INQUIRY) 1 - Q.) 4A0 06,077 c7 IL0J PROT19