Department of Homeland Security U.S, Citizenship and Immigration Services 1-797A, Notice of Action RECEIPT DATE | PRIORINY DATE } PETITIONER | NOTICE DATE PAGE BENEFICIARY —_ | fay 9, 2012 1 fz oyme ¢ training aut bows tax withholding LOWER SAINT NLL PLEASE TEAR (H'F TORM 1-94 PRINTED BEI OW_ AND STAPLE TO ORIGINAL [-4 IF AVAILABLE Detach This Half for Personal Records Po Receipt# Receipt Number 1-94# United States Citizenship and Immigration N AME Services CLASS # 1-94 VALID FROM 05/09/2012 UNTIL 10/31/2014 Departure Record Petitioner: I a Customer Service Telephone: (800) 375-5283 Form 17974 (Rey, 10/3 L/05)N IR 15, Fist (Giver) Name | 6 Date of Hirth 17. Country of Citizeashy SOUTH A Form I-797A (Rev. 10/31/05) N EFTA00543962

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Department of Homeland Security U.S. Citizenship and Immigration Services I-797A, Notice of Action CASE TYPE [125 PETITION NONIMMIGRANT WORKER PETITIONER “BENEFICIARY P} ease see the additional information on the back You will be notified separately about any other cases you filed, LOWER WELDEN REET ITIZENSHIP & IMMIGRATION Svc NT ALBANS VT 05479-0001 | Customer Service Telephone: (800) 375-5283 | Form I797A (Rev. 10/3 L/O5)N - PLEASE TEAR OFF FORM 1.94 PRINTED BELOW. AND STAPLE TU ORIGINAL. 1-95 IF AVAILABLE rs ne | Detach eyylfy! for Peryregiigcorts: = VOID | VOID VOID VOID Rec | Recei ber Vv VOID l- 5 yOID cia 0 | Uniten Ore Citizens Shp and im Immleraion NAMOID VOID VOID | ServicMOID VOI CLAS8ID ~=VOID ~—* VOID VOID VOID VOID PETIMS APR: voID VOID VOID VOID VOID VOID VOID Vol VOID VOID. voip VON VAT VAIN Depa cord VOR itioneVOID \4 Feely Name 15. Fina: (Given) Name 16 Dute of Beer’ ¥' sanry of Cizenstap VOID VOID VOID Vom) _ VOID VOID Vann reves Form T-OjARey- 10/31/05) N EFTA00543963 1? Coe