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Print Prt7278844027022998182.Tif ·.~· • -;1-~D T~ANSM~~AL SLI_P __D_a-te--,-,,-•--· --- TO: (Name, office symbol, room number, ' Initials Date · -bul~dlng, Agency/ .,Post). · 1. ,A. 2 X /· r I\/. ,\, '--"'. 3. - I ·- l 4. ' s. Action FIie Note and Return Approval For Clearance Per Conversation A!3 Requested For Correction Prepare Reply Circulate For Your Information See Me Comment Investigate Signature Coordination Justify ~i~s;___· J:~f)L wtth A--~-o 3 <g i 331/ DO NOT use this form as a RECORD of approvals, concurrences, disposals, clearances, and similar actions . FROM: (Name, org. symbol, Agency/ Post) Room No. - Bldg. ,. Phone No. NSN 7540-00-935·5862 #ft,_ OPTIONAL FORM 41 (Rev. 1·94) 5041-103 . '-7't Pre•crlbed by GSA ~ UNICOR FPI • SST ,, ___ ;.. ~ • ... , UNITED STATES DEPARTMENT OF HOMELAND SECURITY CITIZENSHIP AND IMMIGRATION SERVICES COVER SHEET RECORD OF PROCEEDING This is a permanent record of the Citizenship and Immigration Services. Any part of this record that is removed MUST BE RETURNED after it has served its purpose. INSTRUCTIONS 1. Place a separate cover sheet on the top of each Record of Proceeding. 2. Each Record of Proceeding is to be fastened on the inner left side of the file jacket in chronological order. 3. Any person temporarily removing any part of this record must make, date, and sign a notation to this effect which is to be retained in this record, below the cover sheet. The signer is responsible for replacing the removed material as soon as it has served its purpose. 4. See AM 2710 for detailed instructions. M-175 (Ila¥. 8-31-441 CPO 201-830 .. •, ... --- • • ROUTING AND TRANSMITTAL SLIP TO: NRC Initials KMK Date 6/6/2012 ~ ~ .,:-.. ACTION COMPLETE .:,;,.. c::> c::, t.,.) PLEASE INTERFILE WITH A FILE .(.,.) (.A.) w Cu FCO NRC w FROM Admissibility Review Office Zl l - lOf £ Z t OO 0 PAGE WITHHELD PURSUANT TO (b)(3) d PAGE WITHHELD PURSUANT TO (b)(3) PAGE WITHHELD PURSUANT TO (b)(3) PAGE WITHHELD PURSUANT TO (b)(3) PAGE WITHHELD PURSUANT TO (b)(3) PAGE WITHHELD PURSUANT TO (b)(3) ------·--· PAGE WITHHELD PURSUANT TO (b)(3) PAGE WITHHELD PURSUANT TO (b)(3) (b)(7)(e) PAGE WITHHELD PURSUANT TO (b)(3) (b)(7)(e) PAGE WITHHELD PURSUANT TO (b)(3) (b)(7)(e) PAGE WITHHELD PURSUANT TO (b)(3) (b)(7)(e) PAGE WITHHELD PURSUANT TO (b)(3) (b)(7)(e) CS? Scan~ed Document for IAN F~KILMISTER (LND 0000065795 00. Page 1 of 1 ~ 0 \ U.S. Department of State NONIMMIGRANT VISA APPLICATION - PlfASE TYPE OR PJIJNT YOUR ANSWERS IN ffllt SPACE PROVIDED 8ELOW EACH ITEM (b)(3) 1. Vesspo,1 Number 2. Place o1 ia,unf'lco: City Country l Stato,'Provinr.e 706401119 ASHING TON UNITED STATES OF DC AMERICA 3. Issuing Countrv 4. IHuon-ce Oi0tc (dd-mmm ,,;y'l'/1 s. El(J)lrltlon Oato.fdd·- ·Y)'YY/ GREAT BRITAIN AND NORTHERN 14 MARCH 2007 14 MARCH 2017 IRELANO 6. Svrnamci, (A5 in PilnpOl"tJ l<ILMISTER 7. first ar>d Mlddlo Namos /As Ir, Passport) IAN FRAZER PROFESSIONALLY KNOWN AS LEMMIE 9. Ott,oi flrel ar><.I Mid<lla Nen••• Ua•d 10. Oolo of 8irth (dd-mmm-w,y; 24 DECEMBER 1945 11 , Ptaco ol Bfr!tt: 12. N•tion,lity s,ato!Provlnr.• GREAT BRITAIN ANO STOKE 6~vTRENT GREAT tffl'jtnl_\N AND STAFFORDSHIRE NORTHERN IRELANO NORTHERNIRELAN0 13. Se){ 14. Nalionai )dentlflcetlon Ni.m~b4" 15. Homa: A<Jdrc,s (JrMJu.,J,, .p•tt~nl l'lllfflW. $ttHt, City, ~c•c• w provlnc., ,,osral 1tH11 #m:t "11mt,yJ PXJ Mal• /II •pp/;,;ab/e/ FLAT 3 4 WELLINGTON TERRACE, THE ESPLANDE !!J Foma.1 SANDGATE, KENT CT20 JOY GREAT BRITAIN AND NORTHERN IRELAND 16. Ho,n• Telooh°"" Numbet i S..sino&S P1,one Nunibor : Mob"•ICell Nurnb<)r · 01303 251405 l . I 01981 oJe 921 . F3,c ·Numbor . i8utinass Fex Numb.r ( Pagor M.imbtlr . i ; 17. Metf'i?al Stt.1tus 0 Married 00 S';nglo !Nevar Morrlo'1I 0 Wiciowod O Divorced O Sooarote,j 20. Namo and Addrua of P11s:en1 Emplo.ye,. o, School Norn•: SELF EMPLOYED A.ddrass: 21. Presont O<eupotion /If roriran. wlfte •,~rir~·. If scudenr. 22. When Do You Intend To Arrive In The U.S.1 23. E,Mail Adtlress wn"tt1 •sructsnr".J /P,ovltJ11 s:p,,cili& dz,J, ii known) MUSICIAN 20 AUGUST 2007 24. At Who\ Add1eu Will You St~y in Th• U.S.1 9040 HARRATT STREET WEST HOLL YWOOO, . CA. 90069 25. Name and lelephoo, Numbers of Pe,son in U.S. Who You Wilf Be Staying With or v,sh:ing fo.t Tourism or BualMH II Ii I Ill HIH Y1AS1DXNRO N~m~ i Homo Phono TODD SINGERMAN 1 .. ...... Bua,n<u l'lioeo ................................................................. +c·. 11 ""°"" .......... ................................ -~.. --- 562 908 19S3 26. tfow Long Do You lniond 27. WNI is 1·h• Po,po .. of YOllr Tripi To Stay in Ti,., u.s.1 ONCERT PERFORMANCES ~:i~NTHS ON FIRST ECORDING & PRESS PROMOTIONS 28. Wha Will Pny For Your Trip) 29. Have You Eve., Beon in The U.S.? SINGERMAN [llYea No ENTERTAINMENTS Wt•EN? 07 MAY 2007 ---"-'=-"~------.J(~S~ee!!..EP.!!J<l9BJ8L3:a) FOR How LONGI :1o~P~A... v... s.__ _________ DS-158 03·2006 / (b)(7)(e) 8/17/2007 (b)(6) (b)(3) CS? Scan'.ied Document for JAN F~KlLMISTER (LND 0000065796 00. Page 1 of 1 PERSONAL DATA. Please use 8 LOC!< LETTERS and answer ALL questions, using addltional pages if necessary. 1. SURNAME: l~ILMl'S1E:-(<. FIRST NAMES: \AN rR~"LER .fl.l.__.~SES: I/ I \~oVE,$S1CNAl.L':\ l"\NOlriN A~ i'-.l;::.. MMl£ (Let Maiden Name, Previous Married Name, elc.) 2. DATE OF BIRTH: Q~ -l& · H, <5 3: PLACE OF BIRTH: Si'C>\<6 ON 'l@,Nf -U.J< (Day/Month/Year) (City, Country) 4. If you have been arrested or summoned for, charged with. indicted for, or convicted of a crime of other offense, please g\ve full details including date, place and nature of offense. DATE <JS . O't. ·10 -3\. 1.Q ·71 I I:., . o·~ 7&. ·~, 1&.- ,lo If, as a resul! of any conviction, you served a prison sentence; complete the questions in full: a) DURATION OF SENTENCE ACTUALLY SERVED: ___________ ____ b) PRISON(S) IN WHICH SENTENCE WAS SERVED: _____________ _ c) OATEOF RELEASE FROM PRISON: _________________ _ _ Day/MonthfYear d) DATE OF RELEASE FROM PROBATION: __________________ Day/Month/Year e) DATE PROBATION TERMINATED: _____________________ Day/Month/Year 6. If you have answered "Yes• to question 38 on form OF-156 for any reason other than for an arrest and/or conviction. please explain below. Please include any refevant dates and locations and continue on a separate sheet if necessary. I CERTIFY T Y ANSWERS TO THE ABOVE ARE TRUE AND CORRECT: VCU l May 2007 http://london.usembassy.gov (b)(3) - 8/17/2007 CS? Scan~ed Document for IAN F~KILMISTER (LND 0000065796 00. Page I of 1 :::::}l\·: \ff? ' \. \·,·:\ -::·· In·;;;: ;i.;;: ;~,. 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Scan_ned Document for IAN F~KILMISTER (LND 0000065796 0- Pagel of 1 .• lf-S:'"Department of Justice Immigration ~nd Natunlliia1ion S..•rvk,: Notice ~f Action PETITION FOR A NON!MMIGRANT WORKER RtCF.:ll,-J' IJ.\TE f'l.tllJllH \' ~J .\'Jl·~ April 26, 2006 SINGERMAN ENTERTAINMF.NT r-.1..n·1ct oA.·rr.
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