Uscis Form I-129 "Petition For Nonimmigrant Workers" Page 2

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If you answered “Yes” to any of the questions, please contact the Research and Grants Center to
determine if a license will be needed. Sign below and send this form and the Export Control Certification
form to the Research and Grants Center. The designated official in the Research and Grants Center will
only sign below indicating a license is, or is not required, if a “Yes” is checked. Your signature below
certifies the information you provided above is true and correct, that you have reviewed the export
control regulations, and if a license is required, you will not give the applicant the technical data or
material until a license is received.
__________________________________
_______________________________________
Name of Responsible Party
Responsible Party Signature
Date
__________________________________
_______________________________________
Department
Department Head Signature
Date
Designated Export Control Official
To be completed by
:
If “Yes” is checked above:
A license is required to release technical data/technology to the applicant: □ Yes □ No
_________________________________________
Kathy Ermler, Dean
Date
Graduate School and Distance Education
Adapted from University of Arizona 2011-03-28

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