Form I-854a - Inter-Agency Alien Witness And Informant Record Page 8
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8Part 7. For Department of State/Visa Office Use Only
Forwarded to Consul by VO for Visa Approval
Not Forwarded
Signature
Date (mm/dd/yyyy)
Title
Name
Office Name and Mailing Address
Office Name
Street Number and Name
Apt.
Ste.
Flr.
City or Town
State
ZIP Code
Office Contact Information
Daytime Telephone Number
Fax Number
E-mail Address
Visa Granted
Visa Denied
Date (mm/dd/yyyy)
Signature
Title
Name
Office Name and Mailing Address
Office Name
Street Number and Name
Apt.
Ste.
Flr.
City or Town
State
ZIP Code
Office Contact Information
Daytime Telephone Number
Fax Number
E-mail Address
Form I-854A 07/13/17 N
Page 8 of 8
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Parent category: Legal