Form I-192 - Application For Advance Permission To Enter As A Nonimmigrant Page 8

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Part 7. Additional Information
If you need extra space to provide any additional information within this application, use the space below. If you need more space
than what is provided, you may make copies of this page to complete and file with this application or attach a separate sheet of paper.
Include your name and A-Number (if any) at the top of every sheet; indicate the Page Number, Part Number, and Item Number to
which your answer refers; and sign and date each sheet.
1.
Family Name (Last Name)
Given Name (First Name)
Middle Name
A-
2.
A-Number (if any)
3.
A.
Page Number
B.
Part Number
C.
Item Number
D.
4.
A.
Page Number
B.
Part Number
C.
Item Number
D.
5.
A.
Page Number
B.
Part Number
C.
Item Number
D.
6.
A.
Page Number
B.
Part Number
C.
Item Number
D.
Form I-192 12/23/16 N
Page 8 of 8

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