GSS - Employee Questionnaire: OIS Travel Letter

OIS needs the following information in order to complete your travel package and have it ready for you in time for your trip abroad.

Name Name First Middle Last
VU E-mail Address
Department
Current Status in the U.S.
Do you have a pending permanent residency application?

Do you have a pending permanent residency application? Yes No
Do you have a valid advance parole (I-131) document?

Do you have a valid advance parole (I-131) document? Yes No
Do you hold a valid visa stamp in your passport for your current status?

Do you hold a valid visa stamp in your passport for your current status? Yes No
If yes, scan and email your visa stamp to Ois@vanderbilt.edu
If no, which consulate/embassy will you use to apply for a visa stamp?
Estimated Date of Departure Estimated Date of Departure / MM / DD YYYY
Estimated Date of Return to the U.S. Estimated Date of Return to the U.S. / MM / DD YYYY
I understand that by my signature below:

* In order to re-enter the United States, I must obtain a visa stamp by appearing in person at a U.S. Embassy/Consulate. In most cases, I will contact the Embassy in advance and make an appointment in order to be seen.
* It is my responsibility to make an appointment with the U.S. Embassy/Consulate (http://usembassy.gov) and carry all necessary documents to my visa appointment. I have communicated the estimated time I will be away to my department supervisor. I have read the information about 221g administrative checks.
* If I was in J-1 status prior to H-1B status and subject to the 212(e) home residency requirement, I MUST present the Waiver Recommendation Letter or the original I-612 waiver approval notice issued to me when applying for my visa stamp at the U.S. Embassy/Consulate
* The original I-797 Approval Notice provided in the Travel Package must be returned to VISIT within 1 week of my return to work. If the original I-797 Approval Notice is not returned to VISIT, I will be required to pay the USCIS' $405.00 replacement fee. I must also provide VISIT with a copy of my new I-94 card (front and back) upon my return to ensure continued employment authorization.

Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY

GSS - Employee Questionnaire: OIS Travel Letter

GSS - Employee Questionnaire: OIS Travel Letter

If yes, scan and email your visa stamp to Ois@vanderbilt.edu