Document jB6aQkgZmGwjowgBoRNb7k9vp

Document 57 - Attachment 2 HQ Unclassified foreign National Visits and Assignments Unclassified Foreign National Visits & Assignments Questionnaire Welcome to Depaitment ofEnergy, Headquarters! We are looking forward to your visit or assignment with us. In order to comply with our secmity requirements and ensure that yotu time with the Department of Energy goes smoothly we need to obtain some information from you prior to your arrival. Please take a few minutes to provide the information requested below for each member of your party that is not a U.S. citizen and then return the forrn(s) to your host. Please be sure to comply with the deadlines your host has communicated to you for returning this form. Part 1: Completed by Visitor .Please complete aU questions below, as applicable. See listing of requested documents at end. .1 .Given Name/First Name (exactly as it appears on passport) 2 Middle Name (exactly as it appears on passport) 3 Surname/Last Name (exactly as it appears on passport) 4 Gender 0 Male D Female 5 Are you currently in the United States? 6 Are you Currently a Legal Permanent Resident (LPR) Immigrant Alien of the U.S.? D ves 0 No D Yes (go to question 7) D No (skip question 7) 7 .Immigration & Naturalization (INS A#) Number and Expiration INSA#: Expiration Date: Date 8 Primary Citizenship (Citizenship admitted to United States) 9 Dual Citizenship (if any) Dves 0 No If yes, what Country? 10 Birth Date .11 .Country of Birth 12 City of Birth 13 Institution or Company Name 14 Institution or Company Address and Country 15 Employer Telephone Number 16 Employer Facsimile Number 17 Employer E-mail Address 18 Title/Description of Duties with Employer/Company Sierra Club v. Dept of Energy, 4:25-cv-5027 SC_EVERSPLIT0019821 HQ Unclassified Foreign National Visits and Assignments 19 What is the U.S. Visa Type you will have/require upon arrival in 0A2 0 H1 TN 0F1 J1 0 B1 0 0-1 0 E2 U.S. for this visit, assignment or employment? D Visa Waiver Business (VWB) D Other: D Employment Authorization Document (EAD) Number and Expiration date: 20 Visa Number and Expiration Date (This is the Form 1-94 number; if 1-94 Number: Valid Until Date: J-1 or F-1 visa. 21 Passport Number and Expiration Date (mm/dd/yyyy) Passport Number: Expiration Date: 22 What Country Is Identified On Your Passport As Issuer? 23 Other ID (specify type and number, if applicable) Sierra Club v. Dept of Energy, 4:25-cv-5027 SC_EVERSPLIT0019822 HQ Unclassified foreign National Visits and Assignments PLEASE PROVIDE THE FOLLOWING DOCUMENTS: You will need to bring and present proper documentation of your current immigration status. If you are a Legal Permanent Resident (LPR), the LPR card must be presented before obtaining a badge. If you are NOT a Legal Permanent Resident, you must present sufficient passport, visa and U.S. Citizenship and Immigration Services (USCIS) information to verify identity, authority to work (where applicable to request involved), and current eligibility (in lawful immigration status) to be in the U.S. If you are from Canada or not required to have a passport or visa, you must present a document that establishes your citizenship, (such as birth certificate, citizenship certificate, or passport) and a Government-issued identification that includes a photograph, (such as a passport or driver's license). Please note that this information may be requested in advance from your host. The following additional documents will need to be provided, as applicable: If you have this type of documentation or if this is your status: Legal Permanent Residents (LPR) (Also known as Permanent Resident Aliens, PRA's, and/or "green card" holders) or Conditional Permanent Residents (CPR J>ending Permanent Resident (PPR) [or Employment Authorization Document (EAD)] H-lB - Temporary Employee Visa .0-1 - Extraordinary Ability .0-1 - Extraordinary Ability (Outside U.S.) .J-1 - Exchan!!e Visitor .F-1 - Student Visa .B-1 (Currently inside the U.S.) B-l (Currently outside the U.S.) .Visa Waiver-Business (VWB) (Currently in U.S.) .You will need to present: P ermanent Resident Card (or 1-551 stamp in your passport, ifyou have not received your Permanent Resident card) Employment Authorization Card and the receipt notice from INS indicating your petition for Permanent Residence is pending I-94 Card* 1-94 Card* Passport .1-94 Card* .1-94 Card* and Form 1-20 signed witbjn last 12 months, And *EAD - (Employment Authorization Document *) only ifusing Optional Practical Training (OPT). .l-94 Card* Passport .l-94W Card (small green card stapled in passport, copy front and back). Visa Waiver-Business (VWB) (Currently outside U.S.) E-2 Treaty Trader/Investor Visa (In U.S.) E-2 (Outside U.S.) TN - Canada/Mexico Professionals (In U.S) TN - (Outside U.S.) Passport Note: All VWB's limited to maximum of90 days from Authorized arrival date, but not greater than what actual I-94W displays. 1-94 Card* Passport, 1-94 Card* Passport * White departure record card stapled in your passport. Provide copy of front and back. **NOTE: A driver's license is not acceptable.for proofofbeing in-status with U.S. Government immigration policies. Sierra Club v. Dept of Energy, 4:25-cv-5027 SC_EVERSPLIT0019823