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Ill reply rderto:

CMFT/ULE - h i e Coawl Nun& 2UiB0723

The following is in respmmto wrg!q e o t to the Deptmmt of


m5uNmmkqaD&m*bd-ofm&fid~the;
p v i s b m ofthe Prwhrn of Mrmb Act (5 U.S,C.6 5552).
We have w&eW s search for mm& respomiva to your r q u e
The sa&resulted the* d ofsix doGwmb are reapcmdve to
mW&.* R W ~ W of &€%
&d~~nzayWm1dinfdl.
d0=bX We h~

we did not looate a 1965 p@ortappbtim mfizmced in an


applitadofl far a m m h t o f p a s m tlult is i n c in~the ~
-e-d
documents. Many passpert iipabtims and other non-vital mods @am
that periodwefe destmyed during t b1980sin a a m h w with g u i b w
W n the G m d Sewiceti Administastion.
Passport ~ r d QpMys ~onsistof spplimtions kr UUrirted States
and supporting m i d w e of fZ&W S W citbmship. Pastpmt
m d s da n& inch& &- d f W -sr vi5w,
r e s i a ~ permitsI
e a, she& this infbfimtim is a&& into Zhepasspm
boa- is-=
FORM APPROVED
audsht s U r t 6 A U No. 47-RllT.S

APPLlCATiUN FOR

n AMENDED A S REQUESTED

E be+ m m @ ~ ~ L + ~ h + i # & ~ @ ~ W&the & t t 1 *~ 4irP%cmcm* h& &&a*- WMW~es-gij


*
m . ~ a ~ t C d c i w e m v t a fo+* stare; e n m 6 m m h m a r * m i h rn h d &weomof d ~ ~ i m i c c
ro +rti&P -%- +mrtd w suy$$p die d form-of a fbr* a~atsi;~ c p p t ar~ derf-d rhe &ties af arky &wr pqw, q alp
rhs ~ * ~ i n t a r m f e i g a st* & p o l l i c d s ~ b a h l a i o nheteof; voted ia potiticd eieaian i a B fnr&n stere or pap
a k
plepmzat
ad*& iq = ClrplDn q p-,lo Lbe .-m.osq fy m i+= r fomd*rir(a o f n t i ~ ~ l i @set
tn

-
in tk t t n i ~ e d§rates crr Lime a-dhpl~~at3.c or msulardWcw of tke Unite Ssr+r in a ~-I$EP tifacc; CVI smghl:w claimed bane
fizs of ,&E r~rtrhudt.rp nfstuy b&gm ,smt; or-- tmmictrd %s c o w w k n u r z martis1 of r a m p a e n r ~ & E & c I ~ ~
ofPmhmktinyan$ acr
of u-'s~a agaim+or agtmptine by Fmce r4 almnhhmw, QF kaeiag arms &g~- thc Udtd State, os -$pitis& m wmkow, alrr down
UI r a , ~ , b , t O q e *i ~ ~ ~ th*q%&etl
t - .SnqEqd
a t s or concfiHwr tvrw hsen am-krmed b w w l y to the c p p l l G t , or SO my a # w R-UI
fff m y of k sba-iand
s rh. p-
(qr d U h & i ~ ) Lp
e r , ~ & w i o h
.
+
)o iWi%
~orfian
h ~ ~ H S T
W+RS
S~ l i &
dl.uldb. n d o u ; d . r. k 8 m q
o ~ h . & d LP
d &&d md m& &ti
*
w~nn,
# ~+kr e $
-M
incldd
-qt&
PAGE Z
1 A M E N D T O IHCLUDE ( E X C L W O E I tWIFEI(HUSBAND)
NAME BIRTHPLACE BlRTHOATE
I
I "REVIOYSLV MARRIED T O 1 P R E V I O U I M A R R I A G E T E R M I N A T E D 81
I
DIVORCE: DEATH

DISPOSITION O F M Y SPOUSE'S PREVIOUS PaS5DORT

ATT*CHED Cj CAHCELED
LnATFI

I AMEND TO INCLUDE I E X C L U O E ! CHILDREN I

AMEND T O A E A O IN MARRIED HAME


I
DATE MARRIED PLACE MARRIED MARRIED TO

I
CITIZENSHIP O F H U l e A N O
[7 U. 9. C I T I Z E N a ALIEN-CITIZEN O F

OTHER RMENDMENT~S~ (DESCRIBE IN DETAlL A C T I O N REQUE5TEDl


I

DOCUMENTARY EVIDEYCP SUBMIT TED Y a DEP&RTIAEhlT B Y C D H I U LAR OFFICER

DOCUMEHTARY EVIDENCE SEEN AND R E T U R N E D T 0 A P P L I C A N T B Y C13HSULAROFFICER

STATEMENT O F ACTION BY POST UPOH DEPARTMENT'S AUTHOR1 ZATIOH (70 h eaecwtd only In c o n n c d o n 4 t h costs r e f a d to Dcpt.)

I THE P A SS P O R T

C4RD O F IOENTITY WAS


RENEWEO TO

[3 A M E N D E D 4 5 REQUESTED
09TE

1 1
AUTHOR1 T Y (Consul *I the U n i d S t ~ e so f A r n r r l t f f ) I:
OPINlQN OF CONSULAR O F F I C E R
X
(Y born ? e ~ ' ? c/ot
d irarlmiensJ
i
t t I
STAPLE ONE P H O W HERE
DO NOT MAR FACE

1* Thc passpon photos requifcd must


bc approxirmtdy 2% by 2% inches in r i i c ; -I
bc on thin unglazed papcr, s b w lull front
Z
view of applicant with a plain, lidht back-
2
n:
ground: and h a w been taken within 2 years
o f &tc s u b m i r t d . When dependents asc in-
FJ
3
:
3

-k c l d r d they should be shown inaproup pho-


-
I
tograph. The consul will nor accept photos

I rhnr e r e nor z gmd likeness. Color photo-


graphs arc acccptablc.

x
1"
FORM ,
.
,
oa
(Consul o f ihe Unitmd Stales ef Arnericol
I n certain c a s e s specific auihorizatiom by the lllepaltmcnt will bc rcquized. In chcse r a s e s an extra copy of rhe form should
be prcpnrcd. L'pon receipt of ihc Pepnnmcnt's rcplp the t x r r n copy should bc rtaasmittcd mith a nota'ien of ihc scrion inken+
I
L~ZBARTMENT
QF STATE
WEWaT BY UNITED STATES PIATIQflAL FOR ktd0 REPORT OF
EXCEPTION TD SECTION Bfl,TITLE 22 OF THE CODE OF FEDERAL REGULATIONS
REWST
4-r~ ' c k e n rfifomd that m). PBSS~W~, is Q ~ dF i d d thgr a valid pasispart is required by Irw m dater the
tTr:red Srnr*~.1 reyrasr chat aa ezeptt~11 be gwted w me, as ~ r a ~ i d e
ind%&on 53.2(h1,+Tide 22 09 &e Code
& fee aF $25 is a?qakdWder SeeSon 53JfhJ and t w i d r a d r such h e
t r 6 i;rJem1 W ~ ~ ~ F P ~ * I D P ~ IB kadgrs~aad& a ~
h* PYY+@~C CiSfic= DepSmmt d &areqW w b i n g i m , D.

TC D~mema,P a ~ s p mP~GCQ
ITqamncfit of Sase
Wa+imran, D, C. a 3 2 4
rt-tm; FTJM
rt6BJECT
.W M E IQEERIPT~DPI 5 x 6 ~

&f&SP 20, 39'71 D m , 5&&nsb % ~ p a & 8s shorn above


PLl@#TNUMBER OR VEMEL DF mRRIER'

. - .- -- - -. - -

PLACE flnmhpaf*lc 5m?e#]


W I Wurmlt~&tio?t
~ SCIN~TWREf lmm iusafim Q f f i s t t
FORM A' 3VED BUDGET B U R E A U NO, 47-2059.
7

,Pusspart O f f i c e U s s Only)
DEPARTMEN l O F STATE
APPLICATION FOR AMENDMENT OF PASSPORT Amend a s shown in snctionr

-- El5 a= F I E O F
0

,
INSTRUCTIONS: All requests for inclusion nf pergons must be sworn to (or ofFirrned) 5s-
fare an Agent of the I ) e p ~ r t . m e n tO F Stafe or Clerk of C o w t . Photogro hs. which meet tha
requirements below, and avidsncs of c r t i z e n h i p must be submifted i&r d l parsons to ba
ipcfudsd by this amendment. It such persons L a v e had, or bssn included in, a prsviqus
paraport, i t should ba s u b r n l ~ a dInatscd o f ather docurnants. und Section G tomplmted.
0
Add visa pngss.

P3
-PASSPORT NO. O F A P P L I C A N T 1 DATE 155UED BIRTH tERTIFlCATE(5I SEEM
CHILOIREHI'S I W I FE'SI tHUSBAPI0'~)

M t R R I A G E CERT. INATZ'N. CERT- 1 - --'€R

t l TY STATE rn

IN C A R E O F

(PLEASE P R I N T N A M E I N F U L L )
( F i r s t nwra) (Middle n a m l ( L o s t nanej
w

1, h/7 L
af t h s United Motas, do h sb rs usst that my passport, which i s snclossd, bs amended o s
9 / y s
lndicnted below.
INCLUDE MY CHILD(REH), A S FOLLOWS: (Also cornpletn Sect+on H +f child(ren)
citizenship b y noturolizatibn, and have not hod a previous passpott.)
acquired
1 ""to -quiremem+s for ~ ~ C I U S ~ M ~
i
II
NAME IN FULL PLACE O F El R T H (city, St&=) DATE O F B I R T H STAPLE ONE PHOTO HERE
DO NOT MAR FACE

-I
u
r
Photos must be ONLY of persons +a bm in-
cludsd b y thi s omsdrnant. Ths t w o p h d o s
must be duplicutes. u p p r n x i m ~ m f y
3 inches in size; bs on thin, unglozed
by a =
,
1
w paper with a plmin, light b c k g r w n d and
hove bemn tatsn within 2 vows of date I
I I < submittad. Photos should &=
front VIEW,m
but n e t full-langfh, and m y not L s n q -
INCLUDE MY (WIFE] (HUSBAND), AS FOLLOWS: (Also aornpltts Section H if (wife)
lhus bundl acquired cit lzsnship by natwollzotion, and/or Section I if wife w a s prmviouslv
- she?, Pol arold, =atme or film bass prints. -
h o r r ~ s d&for; Marrh 3, 193l.j When more then 1 person i s t o he Included,
a group ~ b t ios roquirsd. Color photos
(WIFE'S} ( H E B A H D ' S ) FULL LEGAL N A M E PLACE O F B I R T H (City, S m h ) arr occsptnbls.

DATE OF B I R T H D A T E OF MARRIAGE
DO NOT STAPLE SECOND PHOT0
ATTACH B'f P A P E R C L I P 1
7

EXCLUDE PERSCNS, AS FOLLOWS:


WHO I S / A R E

OHY
WIFE [ [=I T O A P P L Y FOR SEPARATE PASSPORT

0MY CHILDREN (GI* n&J)


CHANCE T O READ I N M A R R I E D NAME, A 5 FOLLOWS:
- -- ...- A

PLACE O F MARRlAc
- -. -

W A N G E TO READ AS FOLLOWS:

6 NUMBER
IWI
'~CHILD~REN~*S ) FE'SI ~ H U S B A N D ~ SLAST
I U, 5. PASSPORT
D A T E ISSUED

I N NAME O F UI9 S U B M I T T E O HEREWITH


0OTMER DISPOSITIOH (rim*]
-

(OVER)
tQ 3E COMPLETED BY AFI A P R L r M T REWETTING IWCLUSlBt4 IH THE FAGPORT O F A%RELPITIY E'WHO -@ED
TMROUDH WTU%ALfZATWH
ClTILEMs)+fP
I

-
I
TQ B E CQMPLHED BY AH APILICAHT WHOSE Wl FE %'& PREVIWSLI '~IRIEo BEFORE M A R C H 3. lml, ANQ W O IS TO BE INCLUDE?
1. [el F I - m D R f (If &wi*d M U thwr tweq, e
t forth thw fn v wp.L-tal mrarm~).
I
HER M*YE WU ukze o r ~r(crlsbUs
yn&hiie

Pcace w m t R f n
' P O ~ B RHUS~IMWS M A M I M E Y 4 8 TaRMINATEO Sx DATE
[3 DE*ll+ DlrYQRQL
-
{a THE EVENT DEATH 0. AEE~QENT NOTIPT
) ULMS 1
u PULL REL*TlDMYWf R STREET A P Q R W , STATB

b@ip
p&&p-
entered s-d
ploy~wnr-dm &e $""went uf w &ti@
n l a fareign aar~taken rn oath w made w d t i r m ~ s n0s e r w
h e n s=rurrllizsd ar; a e i f i z ~

in fi erctia ar pletj~d
i a &c m e d hrtrs uf ma foreign mate; r-aed
s w e or p ~ i i e c a~l M ~ i s Q-t;
te trr tIem.hc the mmeignc;gaver 4 4
b n Y
kdtaq;,m&
P
I h*e nor (arid q~ whet ,ptrson h d & d or ts khclnded io dt* p q o r t has), &ce at k g United &axes citirmstJp,
nl ctechmidtl qf Pttgimtc fo

&a
iq either ua tb* U m e d ? t ~ s , , w W f a r idipl~at2r = d s~4tm &C &zed SD==S in a &lpn a q ewe a g h r pr dSm*
-
nr p a f e e d h e &ties of q ~kfiee,posti sr rm-
Q in ~ap&ti$d eieorbb h a br+
d t~aunci*tianbf n3um=I-
. r c ? . ~ ~ ~ a e f l r a d & e n ~ o n & ~ o f ~ & * i ~ ~ ; s r b ~ ~ c ~ a B ~ d b y a c s ~ r tn toj ur r ~i smd ~i eid ~
or

B nPo~f cf~m~ -
mi+g a a 01 n.1- w C I ~ ~ W m we-q, w urns -3s h e ,&U or m.pixiw t.
orwdusw, pur down ar i t j d e s q & b9.rt%, the Gbv.cmmlnr of rhc Uaaited States,

1 sdemlly s m (dim) h.trbe m a t a t s h&i m d e art enrc m d tbar I h m e ~ c previoarly


u a a k d ta h ~ v Me e addi-
&tdperseas b c I o d d in * y @ w w lb a t drey we mt ROW in pssesaiea df valirEpsspa@p,4that Q w h ~wt e made wli-
-d bccn t e w d
e d o n for passp~tts
' -
(PLEASE PRINT OR TYPE PENCIL NOT A C C t P J A B t E j
I
' -
- . 1 I
I I
For Deparhent Decision 1
I DEPARTMENT DF STATE
LarT,oN
POST ACTION
Jakarta. Indonesia

June 2 76 Ex,,,,,

TO BE CONIPLW BY AN APPLICANT WHO BECAME A CITIZEN THROUGH NATURALIZATION


1IMMtERATEDTOTHEU.S.IREStDEDCO~TIFIUDL?SLYINTHEU.S. NATURALlZATlOWCEFITIFICATENO.
(Month, y*ar) From ( Y e a r ) T 0 [Yaar) USubmrlted hersrirh
0k e n and t d w n e d
0Previau.ly aubmittd 11

PLACE NATURAL ZED (Ciry, starel NATURAL1 ZATIDN COURT DATE NATURALIZED

=
1 I

COMPLETE OHLY IF OTHERS ARE TO BE INCLUDED IH PASSPORT OR REGlUMTION AN0 S P M K GROUP PHOTOGRAPH 1I
'L
IWI FE'SJ(HUSBAND'SJ FULL LEGAL N ~ M E

PLACE NATURA LlZEiJ ( C i t y , ~ t u t e )


I N A T I V E BORN
NATURALIZED
NAfURALITATlON COURT
NATURALIZdTlON
u s e e n and mrurnnp
I DATE NATURALfLED
t
I I
I W l ~ d 5 1( H U S B A N ~ ' PLACE
~) OF BIRTH Iclty, Stat* ur Provlnc-, Enuntryl DATE US BIRTH (Ma.. Boy, Y m r )

- .. - - I -- .. ---,
DATE OF B I R T H RESIDED I N U.S. (From-To)
NAME IN FULL OF CHlLDRFH IMCLUDEO PLACE OF B I R T H (City, s t ~ T p r o u i n c o ,cauntw)

-- -

NAMES
.- -

PASSPORT NO.
- -.

D A T E OF IS SUE
-
EVIDENCE OF PRIOR DOCUMEHTAnON DF ABOVE-HAMEI) PERSORS TO BE IIYCLUDED (For completion by Colrsular Dfficel
C A N C E L E O O?
OTHER
DISP3SlTlUN
- I 3 A T E OF REGISTRA-
TION OR
BLRTH R E P O R T
LOCATION D F
OFFICE
-

OTHER E v i D EMCE OF V.5. OTIZCN5HiP PRESENT m TState dirposttlwr)


,PP.TW~EF~.UEEA"ED FXHM u s s i m ru r r , ~
AT
F ~ T H E ZFS$D~~JG rmm z4R 3 Pj?&sS&&
7
MPTWER'S MMD& M M E m . ~ . ~ ~ ~ ~ ~ ~ f

M ~ D L L Y N MYAK D NQT U.L. C~T~ZEM


D4TE NATURALKC@ P M C E MAT URALIZEUGI*, S-ha

4 WARNMQ: ~ a s€abmwr#Pazkhndqgly
l ~ mi ldflttlhh @WtW#Mum er in &daMb nr otket ~upmrtli~ m c m m s m r c e a mawarn a~ grmmlwre 9
k d wl /or 1&- andsr he prnvtsio~sof 18 DSS: r UQ. Ahation w mtttllatim of a p-
w ~ l& USC imwtpufiuaat$ #Ilaw1lc&ion is pmlsb-
$I hWDF IwFkomAen!unQermtfteWiskrs.ef18 11% tH3- W u s a d a mwodTn UbI&n of !tip Wetrow cmihU th&o k sf lhe paspark mgda-
*
finas Isptmkisahla tr)l tiw mdJw imPrrwentuoder U ~94.
,h#nat ahdf~ll&&@!+wincWinb plie@ionhas)I Jnqmuir~~gIJwlW~ciK~b,~mn~mlizedasadlirtlndrferaign~te;~~s
m a h r n ~ a n o r s * + ~ w m a f k l a r r l n ~ i l ~ r i * l l r i s a ~ r D T m ~ Oa r~~ t~n c & d ~ hsbkuwredor
r ~ i @mdWduWd

a:
waWorrlJc~1cm~ubrdaieet~th8MW~~, f
%Ca.WtWWlqmlaZ~~8PYebllRIM0fm3hn n ~ a r p i ~ a a I 1 * l i ~ 1 m ~ ~ ~ 3 ~ a ~ ~ ~ w c i a Y m ~ w ~ i ~ i 1
ah~@a~~~solrgtli$~~iaid~he~ibgftk~~m~i~daay#oreigns~tat$;m
cslqar y f r l n#s( alunebn)iul&~d6Pnnr ~ y . a cBhsan
t a&%,x &h&rtp by ld WHhrmi w Wig Irmswimt,thl Ufllbl Lbs
IQ awguax.)ddan w lodeshy gy l m ; ~~o t x ! m r naa~unit6dw&
or cq~ina l
f l f q d t h ~ m m & ~ c r r d b b h , p ~ b y a r s g p r y w &
Iw *A&*- sd
d d d h - d u J ~ ,d * U l i * I M e b p l m & * . l a r
i~&orwaryr[t+ k h l d W i ~ e ~ + p c ~ f s # j ~ n , f h +
Em b * n n L ~t d k~ ! i d ! e s h w l d
E~mni
b w 1 M 1
araM m m k m p w r d r k l s ~ t ~ ]
wear (or a
rm)mat &+I &emtb Wa #I all C p p v f Ibis . ~ ~ l ~r~rB
t1
h1ntbt the pkob& &chee is a krrrof rn a l l of tbar P ~ M I
t o b e t dedklIllsC~a
.
T O BE COMPLETED BY AN APPLICANT WHO BECAME A CITIZEN THROUGH NAftlRALIZATIOM
lMMlG RATED T 3 f HE r R E S I D E D CONTINUQCjSLY I N TuE N A T c l R 1LIZATION CERf 4 F I C A 7 E NO.
J.S. (Monrh, year) U.S. From (Year) T o (Year) 0 Subm bed hermlm
I2 Ssen and returned
Previou~lysubrnltred
'LACE HATURALISEU (Citv, statel U 2 i l J R ' A L l Z A T 1 3 N COURT IDATE NATURALIZED
I
TO BE COMPtEf ED BY ALL APPLICANTS
-

3CCUPATION V I S I B L E DtSTIIVGUISHIb4G MARKS


PROGRAM OFFICER, FORD FOUNDATION none
-EN W T a P m E WLLOYVlNG fF CHILDREU OF A PREVIOCR MARRIAGE ARE WLUPED OR 1F PR€VW.SlY W R E D BEFORE W W 3 " 1931
I WAS PREVIOUSI,Y MARRIED ON \ T O (Fult legal name) (WHO W A S BORN A T ( C i t y , St*, Countrv)

ON (Date of bimh) [IFORMER HUSBAND WAS U.S. ClSlZEN [PREVIOUS M A R R I A G E TERMINATED B Y DEATH DIVORCE a
I
FORMER HUSBAND WAS NOT U.S. CIRZEN l o l ~
ID-,
~ ~ N P L ~ I F A F P U C A N F D R A N Y P E ~ ~ ~ ~ ~ N ~ I D N B W P S N O T ~ N I W ~ U
E A E D T H E U.S.
€+If {Mon~h) (Year) I F FAT HER NATURALIZED: I IF KNOWN, FATHER'S R S I D E N C E
PHYSICAL PRESENCE 1N U.S.
0 Applizam Date Certiflcats No.
From (Year) f a (Year)
W ~ B
13 Husbsnd Before ( N m of Court) Place IClty, Stme)
Child

RESIDP~~~CE/CONTINUOUS PHYSICAL 1F MOTHER NATURALIZED: IF KNOW, WTHEUS RESIDEME


PRESENCE IN U.S. F r ~ r n ( Y s a r T
j o (Yssr) PHYSICAL PFlESENCE I N U.S.
Dete Certificate No.
Appliant F m m IYeer) To 1Year)

I I
1 7 I I

I INTEND TO CONTINUE TO R E S I D E ABROAD F O R THE FOLLOWTNG PERrOD A N D PURPOSE

Two years c o n t r a c t w i t h Ford Foundation f r o m January 1981 - December 1982.

II~TENDTORETURNTDTHEUNITEDSTATESPEAMANENTLV DATEOFDEPARTURE
4 YEARS MONTHS
1 PRlVACY ACT STATEMENT
T& Information snlieln?d an this f d m is authorized by but n o t limited to, tho= statutes codified In T i t l m 8, 18, and 2% 4JnimdSt.TosCodq m d *I1
pmdecmsor rt;lu.ttes wketker or n o t codified, and s)t re&lation$ issued pursuant to Ewmcutiue D r h r 11295 of August 5, 1966. The p r l m put'PUM ~ ~ for
.ollciting the information Is t o esrablish citizenshipr Identiq and e n t i t l m e m to Issuance 8+ a Unlwd States P m p o n or raja& ftsllity, and t o prupetly
admlnisrer and enforce tha E m s psrtaining rherato.
The i n f o m a t i a n ismade available as a routine urn on a need-*know ba~k l the C h p a r t m e n t of S m and ethw gwwnmmnt agenele~
te p s r s ~ n n eof hwlng
statutory o r other lewful authoriw t o maintain mch information i n t h e perfmmanfa af their officlal dutias; purarantm ambpoenr 8 r court ardor; and,
~s sat forth i n Parr 6 4 Titye 22, Code of Federal Regukitions {Sea Federal Register Volume do, pages 45755, 45156, 47419 and 67420).

Failure t8 prwids the lrrfwmffio~ requested ~xrt h i s form may rmlt I n the denial of a United Srateo P w o r t , rel~t9ddocurnant or 5 a ~ k OtO h6
indlvldusl seeking w c h psgspoq docwmenr Qr service.
NOTE: The dischsurs of your Sacial Security hlurnbw or d the identin, and locattan r ~ a f p e m t m bs no~ifisdIn t h m went Of dmath mT rcidmnt JI
entirely voluntary. H owwwr, failure to pmvida this in+wmadon may p r w e n t the Depanment of State f r m prwiding y w wWh rlmely armlstance or
p r o m t i o n i n the went you s h w l d anceunrer an emergency s i r u a e - 1 whFle oumlde The United Stams.

ACTS OR CONDITIONS
(IF m y of me baluwmentioned acts or conditions have b m n parfwmed by e r q p l y t o the applieanf or t o any other p-n ta bn lncluded i n t h m
passport, the pOrtIcxl which appli- should be s m c k out. and a supplemenmry e*otanatnry statement undw oath (or affirmation) by t k e par-n t o whom
t h e partion is applicable should be attsched and made a p a r t af fhiq application.)
1 have not (end no other wrron included i n ?his appllcatlan has}, since acqulrlng Vnimd S- citizenship, m n naturatizedas a citlren M a f w o i g n m;
taken an ash Or made an affirmation or oMsr formal declaration 0 7 allegiance m a f o r e g n stare: enrered or mwud In t h e armad forcm nf sforeinn smm;
a c e p t e d or performed the dutiee of any office, post, o r employment under the govwnment of 8 forelgn rtam or political subdivl~ionthererrf: made s
fo~rnatranunclatiun of nationality either in the United S tams or b d o r e a diplomatic or conwlar officer of t h e United S t a a s in a toreign State; svsr W Q h t
or claimed the twnefirs of the netionaliry of any foreign %taw:or been convicted by a court or court rnartlal of compefant jurisdiction committing anv
a ~ of t meason aga;nst. or atrsmpting by force to overthrow, o r beaing arms ageinst, t,a UniTed Stares, or conspiring to ovmrthrm, put down or t o
desnoy by force, rhe Government of rhe United States
W k R N I N G : False starementr made knowingrv and willfully i n pasport applicwions or i n aFTi&vits Or rimer flupporting doturnsnu rubrnltQdTherewith
are punishabla by f i v e and/or imprlwnmenr under the provisions uf 18 USC t Wl and/or 18 USC 7542. Alteration or rnurilalon of a paaaort Imnd
pursuant t o t h i s application is punishable by fine and/or irnprlaonmsnt under the pmvisians of 18 USC 1563. T h e use of a p a w a r t in wiolstim Of the
restriction5 contained therein or Of the p a s p o r t regulations is punishable by fine and/or imprisunment under 18 USC 1544. A lr stetemmts end
documents submirwd are rubjeet m verificaricn.

IFOR USE OF OFFICE TAKING APPLlCATlONl


- -

IDENTIFYING O O C U M E N T ~ I
~PPL~CANT'S I D E N T I F Y l N G DOCUMENT lS)OF WIFEIHUSBAFTD T 0 BE INCLUDED
I N PASSPORT
CeMfieate of Natural- Certificam of Natural-
lzation or Citizenship No.: izarion or Cirirenshlp No.:
U PBSSPOTT 1 ~ D ~m :9 Passpart lreue Oa*:
Urivefs Liceme Place of Issue: , n Driver's License Plaee of ! w e :
Tthur lSc;acifyJ: !$mud In Name OE C] 0rhet ( S P ~ C W Y ) : lasued i n Name of:
W/CM/T&
c l t y . - w d
COLOR OF WAtR ~ F ( O F ~
P.O. Box 648010
Lee's Summit, MO 64064-8010

July 29, 2010

Mr. Kenneth Allen


10055 E. Gray Hawk Drive
Tucson, AZ 85730

Dear Mr. Allen:

We have completed the review of all documents responsive to your Freedom of Information Act (FOIA)
request of March 1, 2009, for records concerning individuals you have identified as “Stanley Ann Obama,
aka Stanley Ann Dunham, aka Stanley Ann Soetoro” and “Lolo Soetoro.”

We have identified 111 pages of documents responsive to your request. Enclosed are 83 pages which are
released to you in their entirety, and six pages released in part. We are withholding seven pages in full.
In our review of the aforementioned documents, we have determined that the redacted portions contain no
reasonable segregable, non-exempt information. We have referred 16 pages to the U.S. Department of
State for their direct response to you. All responsive information known to exist is hereby released to you
with the exception of those portions that are exempt from disclosure pursuant to FOIA exemptions (b)(3)
(as applied in conjunction with subsection 6103(a) of the Internal Revenue Code (IRC)) and
(b)(6). See 5 U.S.C. §§ 552(b)((3) and -(b)(6); IRC § 6103(a).

The following exemptions are applicable:

Freedom of Information Act, 5 U.S.C. § 552(b)(3) in conjunction with IRC § 6103(a)

Exemption (b)(3) provides protection for information specifically exempted from disclosure by statute,
provided that such statute requires that the matters be withheld from the public in such a manner as to
leave no discretion on the issue, or establishes particular criteria for withholding or refers to particular
types of matter to be withheld. Exemption (b)(3) is being asserted in conjunction with subsection 6103(a)
of the Internal Revenue Code (IRC § 6103(a)).

Subsection 6103(a) of the Internal Revenue Code states, generally, that no officer or employee of the
United States shall disclose any “return” or “return information” (as those terms are defined by
subsections 6103(b)(1) and –(2)(A), respectively) obtained by him in any manner in connection with his
service as such an officer or employee or otherwise or under the provisions of section 6103, except as
authorized by the Internal Revenue Code. Subsection 6103(a) leaves the deciding agency official no
alternative or discretion on the issue.

FOIA exemption (b)(3) is being asserted in conjunction with IRC § 6103(a) to protect certain returns and
return information found in a record responsive to your FOIA request. After meticulous analysis and
careful consideration, none of the exceptions to this strict statutory prohibition against disclosure was
found to be applicable to your request. Accordingly, the USCIS has no discretion on the issue, and must
deny your request for access to the same.
Page 2 – Freedom of Information Act Request of Kenneth Allen

Freedom of Information Act 5 U.S.C. § 552 (b)(6)

Exemption (b)(6) permits the government to withhold all information about individuals in personnel,
medical and similar files where the disclosure of such information would constitute a clearly unwarranted
invasion of personal privacy.

Records responsive to your request were located in a Privacy Act protected system of records referred to
as the Alien File/Central Index System (A-file/CIS – DHS/CIS 001).” See 72 Fed. Reg. 1755 (Tuesday
January 16, 2007). This system of records contains information regarding aliens who have sought
benefits under the immigration and nationality laws of this country; these records are collectively referred
to as alien registration files or “A-files.” A-files are universally recognized as being similar in character
to personnel and medical records (inasmuch as they contain some of the most sensitive and intimate
details associated with aliens who have sought benefits under U.S. immigration laws) and, thus, are
entitled to the protection from disclosure afforded under FOIA exemption (b)(6).

In deciding the disclosure disposition of those documents containing personal details lifted from the lives
of private individuals, the documents were closely scrutinized in an effort to identify any public benefit to
be gained from their disclosure. It was ultimately determined that no discernable public gain would be
achieved from the disclosure of the information subject to this review. On the other hand, the potential
private harm that could be suffered as a result of the release of this information was found not only to be
tangible, but also significant and reasonably probable. In the case of these documents, the potential
private harm stemming from their release was determined to clearly outweigh the total absence of any
public benefit to be gained from such disclosure. Consistent with this analysis, it has been concluded that
the release of the subject information would constitute a clearly unwarranted invasion of the personal
privacy of the individual(s) to whom it pertains. The USCIS, therefore, must deny your request for access
to this information under the authority of FOIA exemption (b)(6).

The enclosed record consists of the best reproducible copies available.

Sincerely,
T. Diane Cejka
Director

Enclosure(s)
Ac?sIIon No. Box PtP,pn~:..,-.; ., .,,';DmC m
. . .-
I C O ~ ~ ~ C1.b~. L G Soetoro
~ by toloi,i~one (i:9113-9952) on 21, 1?7&.
5!1c advised t i ~ a ' is!le ~ o i i l dco~tac.1her: husbold aici have him raturn his
roontxy p0rnri.t e.nd a!~plicoVLon (F01-m 1-131) .Go t i l i s ofl'ico sc soon as
poszible s o t l ~ a i ;we hmy complete tht adjudicntiono
fl
John F. OIShe6
District D'Irector !T .-. f- '".M
Unlted States bepartment of Justice
Immigration and N~turallzatlonService Tfl
Dear Mr. O'Shea,

ms I Informed you by telephone, the hmericpn Embassy i s


refusing my husband an extension of reentry permit on the grounds
that he f.lled a 1973 .non-resldent tax return. T h i s erroneous infor-
matltiri I
s based on 8 .letter sent by your olfloe (Item I enclosed) .
My husband, p r i o r to departing for DJctktirtc on business, :fl!ed
a 1973 resident. tax return. Enclosed is a copy of that return (Item 2).
The lac1 ..that It i s a resident form is clearly stated at the top of the
second page. In addition 1 have v.islted .the downtown tax office and
had them verily that i t was a resident form. Non-fiesldent lorrns have
a special N.R. initial In the upper left-hand corner. Lastly I have
enclosed copies of my husbands 1973 wage and tnx statement, should
you need them.

I f you could clear up thls mlstake as soon as possible by nqtifying


the U.S. Cm.bussy In DJakarta il :@o~$d be greatly appreclalad. My
husband hopes to return lo Honoluli next month. If you have made a
decision on the matter I would also -pprec.iate a call from you o r your
secretary. Y0.u oan reach me d t home el 941-9958. Thank you .so
much for your t~ouble.

M r s . H n n Soetoro .
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. . ., . . . . . A30 48L 285 .'
>?
,
.!
! "
. . .
. .. : . . . .. . . 'JW'ED STATESDEPARTMENT OF,1IUnICE:: . . :.: : .. :
. .
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:
- . IMMlGRATlON AND NAT~JRALIZAT~ON
' SERVICE
>
. . . "
;

AL.4 MOANA aLVD., P.O.


HAWAII,sa
HONOLULU,
'pebbNw"'28; 1974 *
,. .i T

Lo10 SO3iORO
c/o Di_oosegoro 7
DJ&&a, Indonesia

In connection with your application forkextens&n of


rftn*
-P.ernit,
. t h e iollo2Ang i s brought t o your ettention:
After you were edmitted es a lawful permanent:
resident of t h e U~litedStates uncles the M g r a t i o n
l a m , and. aft;er you estebLished e.r.esidence in.
%Uscountty, you elected 3 claim nowesident
Status $0 q u e l i ? ~foqybenefits uncler tfie Federal
i n c o n i ~ ~1a:dk
q. Such c-hce-tnt
wit&&pntin=of a t e t u s es a i a w ger-
. . . maneqC_~.esidentunder the hrmigration laws'."

I:. '.the purpose of this l e t t e r i s t o nive YOU an o u n ----u


t o submit, if you wish t o do so, eqy e&e- or e m -
o ~ t v .- ~

before a decA&uAs nade on your.epp~ication. Any submission


y o u ~ a ~ , K i st o
h a e k e mbst be r e c e i v g , : & $ ~ $ ~ 3 O - ~ f r ~ -
dgte of this l,ette?i:f no submission is reoeived frm,.you
w i t W tKe time allowed, the decision on your e ~ l i c a t i o n
w i l l be made on the b e s i s of tho evidence
... o"A record.

fiincerely,
$$UL cPf&l&L; . 5$f
John B. O'Shea
D~~!!z?~~..?~~~sf?.Qr
1.
.k11~.&, .CQT yo!yf' 1 :.1,4t1:p'
;I,c)~: ~ $.a
,... -!;,9 l s ~ ~ ~ 1 . y 1'9ql.l r eg.a!.'r:'j:r!,y tlie
r:r<Lker a!' w y pk?a~fl\o;~li?r~t,~r:%ident a b8hu.y. 5 r.;i.l :; cc:c>utplet:~!l.yurhv!.srs % \ 1 ~ t
I 11uB cnntr'zven€!~l .ar;y E'sti.ara1 law. hly oniy ;.xpT~.~~aLi.on iz 2;ha.t n/'~e:r:
. .
I i'jlled o u t izy Lc:x ~ O P J If a r 'i373, I snli3te:i d ~ k i c?~i:J,p 0,"s L'lsJ.rrr~d.
%a \t,orirei.i. f a r tt bijnk ~ . n d\;IC~.L: uv;!pe 0.l' lay :;t?:;tus tLi~~s.~lfiI t~'~ster3 5.1.1
h i s Icno;~:?.of',geo r tl,~..\e
Ca,: Isi.'~.

-
i . . I l!o,pe ,tt:!:-L ",:)is incl,1$a3t c!j.l.? !11.~-1 j:.ap:i S5.8:" iny
:!hctnces o f ar1 exten!.;:l.on 33 IIIY re-c::rl,lay pt:rtlrl.'t.
Per relepl!onc
convcmnuon ,0 0 1 1 1 lllC KxI.
Remniks

-
From' Room
IMMIGIIhTIOII AND N I T U R A L I Z A T I O N SERVICE
.. "
STATE OF HAWAII
DEPARTYENT ATTORNEY GENERAL .
BUREAU OF CRIME STATISTICS fkIDENTIFICATION
KANAINA BUILDING, CAPITOL GROUNDS
HONOLULU, HAWAII 96813
T~.~ C TE
XXS nn:' cowcz~s:
ABSTRACT OF CRIMINAL RECORD

Our Number
--- Date
J u l y 18, 1972

The following record is furnished FOR OFFICIAL USE ONLY, Information shown on thk identification
record represents data furnished by all Police Departments in the State of Hawaii and the Hawaii State
.
Prison.

$or Director
m..,,.-< s?..- ,-..,"
. ,UNITED STATES DEPARTMENT OF JUSTICE
.'
',
las ek
IMMIGRATION AND NATURALIZATION SERVICE
new w MOINA BLYD.
HONOLULU, HAWAII 88808
AwWt @J 3958

Mrs. A m D. Boetoro
2234 llpiversity Avenue
mlduJ-
1

is in reference to 'app12cakion far Wver of


.the two-year fore* residence re@Brnent fjJ.ed by pur
hueband, f i a b Boetoro.
Our records inaicafe fhat your hutrbtrna rebmned
t o m s i a , the countay of hia mG1.Mallty 8nd laat
residence on ~ d m,y M6. ~tqpears therefore that
he has aocumulated the twoyeare of phyaiaal. presenoe
in mdanesla and %at there iQ no need to consider tha
application for a v e r at time.
We ewe therefore considering ehe a~e~Uc8tiOn
closed, honwer, gf st any f i u it ia found fhsf coneider-
ation ef the waiver w c a f i o n6.! neceesary the m a t e wUI
be reopened.
Sincerely,
U. S. DEPARTMENT OF JUSTICE
IMMlGRAnON AND NATURAUZATDN SERVlCE
555 ALA MOANA BOULEVARD I n n r ~ ~ . ; ~ i SEN
HONOLULU. HAWAII 96813 l j E , T._ -.~ n ~ r - ~ . ~ T l ~ f l
cc:isi;E
OFFICIAL BUSINESS
Ftie NNumll$lh. . *.........
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. .

L A. Chksifi~tlon:. . . . . . . . . ~ i < ~ g~. .& $ ~ ,


...............

C] The $tition :hask e n revalideted. fjo notice ;i[ revelidation ~f:~e~etlt~~n?h&.be~nrsent~:t~~.a~~~dit~.d


.States Consulnte, eri Pt.has:qot beea.indicqted:that the..benefida&(i?s);#yilSapply.for ~:i~g{s).
a:lf:@u..befome
./.... ........
na@,w.~ed~&;s.cit&en ?f.:ihe ~ n i t ~ ' ~ t ~ t e s . . ~ n ~ . a D . ~ i ~ i g r ~ tb&t . ~ i s i i h ~ ; n ~ ~ ~ ~
..;u@ B . u ~@ t i i e : b ~ m ~ $ a & ~ ~ t :hi ~i ~~i ~f ~~ f € i ~ e : j ~ ~ . ~ ~ ~ ~ ~ ; ~ i ~ i ~ ~ ~ ~ ~ . ~ ~ ~ ~ ~ t : + y :
. an.krmadkq g ~ y ; ~ , ~ ~ f ~ ~ ~: q~ ~~- ~; ~~~ ~, sc ~, ~ e~ ~: ~. :: ~o~ fn e ~ ~ ~~isii2%&liti1f:b~1 I I . ~ f ' ~ : : p e ~ t i ~ n '$
..,m,FT sbti,:ar:.~eu',&te.t
........ .:.> . . ....- ...
,..;.Ia @:~$$@~~.%he<het~:th'@r:.~g~an $6 still-~+jrrie&:::,. .$f
'a.%&i ~ ~ ~ ~ g u i . r e d : ~ ~6ffi&:hibmptl$~?GiB
~ljatift
.....................
~ 6 $ f i l b y m i t ~ C ; @ i j ~ a @ - @ . . $ ~ : 1 . ~ j ~ p e ~ ~$ ~ ~
..is.t-~iinirietti;d.~tiefo~-~e~.;txp'mti~ iii'the,aa~ilied:~~~.:ifi:th&#~iea;i.'~f~t~~~~fiij.~gtfg~cw~~
... i.ri.( .... .
o w .You ' ~ . r ~ u e e t e d ' : t o . - a d ~ ~ b& t a ht p , ~ ~ . ~ ,J.>:.; ~ ,.,~.. > ~ ~ - d f : . e ~
s d~f+i ~e i- ~ . ( i ~ + ) : t h
-fiat spedfied in W@.pedti~n.wil1. be.o:"iol~~(In of thq~on~mmimt~~~~t~s.:~f:th,~'~#@~g~F,vi~e;83:
a:I,&on.:dyal.inthe-?Jni1qd$tateP, the initial,,perid sf .admi'&qi~.#::~f. the ~ n e , ~ d i ~ < i ' ~ s ~ : ~ ~ a ~ n o n - .
*:Wt.-visa .e$$bF.,m.?y pot.,exce,edthe.d$eto whloh.llie p ~ ~ l i p n ~ i ~ ~ v . a l i d i
a ~ ~ e ~ m ~ ~ . i ~ t s ~ , o f i ~ e ~ b ~ p e f l c in-y~t~peUt.i9,g i a .r y (. i t i ~ 'is~xiepdea
).~,~~ed LO

Jr'~j&&4&&

4tlSrBlJ
Memorandum 90
IC vc

PROM : J. P. a h ~ ~ hsistant
~n, Regionel Canrmissioner,
Travel Control, Southwest Reeon
sunjecr: ~ l 128
4 294, Lolo Soetoro - Section 212(e) Waiver Ap~Ucant

a b j e c t f i l e i s returned. me Centxe office on october 6,


1967 malled your letter on this case t o Bparbent of State
wifh favorable 'recommendation.

Attachment
PIemnraadum to f i l e
A '4 '28 9 4
Sept. '4, 96'7

Pursuant ta inquiry frnm centre' office regarding the status


of the applicantsl apouee.91 chiqd by a fnrmsr marriage.
The person i n question irP a united etatee citizen by v,ptue
of h i s birth in ~onn'u'u, Hawaii Aug.,4, '96'. He ie iving
with the a~plicantel s p u s e i n Hnno u u, Hawaii. He mdmxhcs
le considered the .app'icente atepchi'd, w i t h i n the meaning cb
,
Sec. '0' (b) (' ) (B) of the act, by v-e qf We marriage nf the
app'icant t o c h i dat mother on March 5, 965
~sgioaral-ioner
8Bn Pedro, GelLeorPla

'We epplfcaat's file in tamed breerltb. It ie tkta op- oP'


tkie ofOi4m tbst ampMauet Wdebip bse been eetebItehed in thls
aaeo tor tEa f b L l e w h $ rerreoner
Theeeplfesnt, abm refxumd to maEee&.aod hee been
mi- thwe fer over 13 mtba PII an &fort to 8 a w
tb fiore&a weSdmaa mqukcwmt, earae e veap uw%er eeLsrp
end 18 dapBOdOBt upon W e r e of hk, fendty. IUe &e b e
w d hr ebe WtedP.&iW aa8 8Ewlt $4tN 8
BbaW nrw detemdmd'm JoloBeu hu6baEd Lo X a Q a a e l e if
h e i e o o t p ~ c B e d t o r e t u a n h w e ~ ~ ~ ~ e b a o a n ~ ~
e u b a tBa e ~ m h l c a . She bee bean erg- 6- taet year
to ob- wlegsreno tb 0.8. -y i B DJSk8ito.
l(ndeoeeh, taPe frtt rsL-llt 8-. d she V l l l tbmmSS be
~~ e&quaa llmam ro wpport a u and her mZnor Bolr
o f a p m v h m ~ ; # i 8 $ e t J b o w i l l her
~ tbmr
ts no- ~n file 0 ~ m t tba m statue og t b b m e * e
eon. Pleeae 4fquSm inDo eieiaenshfsr and mSdraaool 6-m sod
bebrudua rPhetlrer or not Bo te tbe applicent'e &&Id vltbta b
a w m i g ef Saotfoa 1@l(b)(L)@) oE eha Act. s!ko rimy -Per asaeptlccoan
har&b4 IS%- the 09.8a~ltfaa2L2<4.
.hen the wmpr~etrsleator kee bean at- pleaee ma& it hie -
rage&? osttb tka applkenrge ffle for f o r ~ ~ ~ c I i sto
& ehe D q a r ~
of Stete.
TO :. District Director
Honolulu, Hawaii
,PROM .: J. P. Sharon, Assist ant Regional C d s s i o n e r ,
Travel Control, Southwest Region
$uBPm:, 128 294, U l o Soetoro - Section 2E(e) Waiver 4pPlicant
Subject f i l e is returned making reference t o CO 2l2.43-C of January 5,
1967 requesting that your previously mepared l e t t e r of denial be brought
up to date for reconsideration by the Central Office.

Your previous l e t t e r of denial submitted wilih your memorandum of December 13,


1966 should be revised accordingly.

Attachment
m?s&Lmnma*m*Bobulte

awwez m-
PI
-
.,. .
(
' I,.
, .-.;
Memorandum
.To .:. District Mrector
Homlulu, Hawaii
.PROM :, J. P. Sharon, Assistant Regional Crmrmissioner,
Travel Control, Southwest RegLon
.suBJEm: A14 128 294, Iblo Soetoro - Section U ( e ) Waiver Applicant
Subject f i l e has been reviewea by Che Central Office. Attached CO 212.43-c
of Janutuy 5, 1967 by the Assistant Camiesioner, Acljudications indicates
the view6 of the Central Office. We concur.

€ubJect f i l e is returned for your further actiop a s indicated. P h e


return f i l e with your cannnente aft;er: the requestea action has been taken.
C"1 6
UNITED STATES DEPARTMENT OF JUSTICE
IMMIGRATION AND NATURALIUTIOM SERVICE
RECORlf 012 §WORN STAnrRlENT IN AFFIDAVIT FORM
MFmAW
QJ RE: SOYIYIRO. Lo10 ILE NO, A U . 128 294
EXECUTEDAT Honolulu, Iiawaii :ATE NOV. 31, 1965
Before the following officer of the U.S. Lmmigration and Naturalization Service:
hank R. Potter, Immigrant Inspector

1,
S.Ann Soetobo , acknowledge that the above-named officer
has identified himself to me as an officer of the United States Immigxation and Naturalization
Service authorized by law to administer oaths and take testimony in connection with the enforcement
of the Immigration and Nationality laws of the United States. Re has informed me that he desires
to take my swam statement in the above matter pursuant to such authority. I am wilting to make
such a statement. He has told me that my statement must be made freely and voluntarily and may
be used against me or any other person i n immigration and Naturalization Service proceedings.

Being duly sworn, I make the following statement: true md c o r r e c t name is Stanley
A n n Soetoro and I am Got 1cnpn.m by any other names except Stanley Ann Dunham. I
am shovrn as Stanley A n n Dunham on the records of the University of Hawaii. I am
a citizen of the United States by v i r t u e of my b i r t h i n Vlichita, Mabsas. I am
married t o k l o Soetoro. He was a student with me a t the University of Hawaii as
an exchange v i s i t o r .
He applied t o the U.S. Innigration & Naturalization Service f o r a waiver of the
two year residence reql~isementof the Inunigration and Nationality Act. The basis of
t h i s anolication vas the h a r d s h i ~that his abaence would have caused me. Evidence

I am now l i v i n g with my parents i n the home which they r e n t here i n Honolulu


near the University. biy son by a former marriage l i v e s t h e r e with us.
As hardship i s defined under t h e 1.resent laws, I don't f e e l t h a t I would undergo any
exceptional hardship i f ny husband were t o depart from t h e United t o reside abroad
as the reguzations require,
I have read the above statement and it i s a true and c o r r e c t s t a
the best of my opinion.

8. Ann Soetoro
SV:OHN TO AND SUBSCRI8ED BEFORE Mi3 THIS 30th DAY OF iVOMm, 1965 AT
HONOLULU, HAIfAII.
,. , 'Fy b,uqb.qid.le&. Y . y @ 20, .496,6 and ~ ~ abnck,dq;b.h~l~a~t.a.;
t , He.
,,! '
4 4 8 :.wqrlcfi&:Etir.
:he , Jniiansa$& .~oye~,ent;.&opducf'Lng a 'CQpo-
'.... , ?.\
, I / ,,era&fc@$,::,'auf,*y, .he.$; liiyin&.,.i3!'.hhouse tliai::halorigi t o . a
.rell&kiy$.;.
peeojo erTa
-
p e ~ o j ~ r ~ ~ - I
'0.8 0% W1-D
peae6o~aC ~ T - 37 - .
rda
oil
$61 w-a
0% +G-I
-

-a
:w
in,

ii
' 01
I em submir;%ingthis statemen% o r expranation in t h e
knowledge t h a t , shotiid I f a l l t o get t h i two-year foreign
residence, requiremeni; waved, i%
would m u s e great hard-
s h i p on my wife and have a disasterous effect; on both our
lives.
'mwue, Ann ~ o e t o r o ,i s a c i t i z e n of the Uniiied
States and has resided here ell her l!%fe, It i s preseniilg
impossible f o r my wile t o return t o Indonesie with me.
The raasons a r e multiple. Financially, both of us h a m
been students, %here i s no way I can acc.muiate t h e paasage.
money (more than &00 f o r my: wif8. albne) + Within Indoaes5a
i t s e l f , eoonomi'c c r i s i s is; so widespread a t t h e present
time t h a t the salary of even a aollege graduate provides
a srandard of Living bordering on poverty- Most ihrpoY?tantJ!y,
anti-American feel* bas. reached a f e v e r i s h p i t c h under'
the direction of the Indones2an UomunSek party, and I ham.
been advised by: both f&y and i r i a n a s Sn Inaonesiu a t
it would tie dsngerous to enaeavor t o beturn w i t h my wife
a t the present time. O f secondary imp0rtaXICe is: t h e fact
that m y ~ J l f edoes not yet speak Indonesian, Not o d y woad
she be forced t o cut short her college eduoation, but she
would be l e f t in a position of isoZation. i n t h e community,
FaiUag a waver, tlien, my only a l t e r n a t i v e would be
t o leave my vtife on her own and return aZone to. Indonesia.
But t h f s too is f i11ed with d i f f i c a t f e s .wwife bas.
had no work experience and, her education being stWC in-
complete, she i s ill-prepared t o be self-supporting. Yet',
. .
n e s $ a n ' g o ~ ~ n n mis~ tno 1ionger able; t o guarantee. the safety
of corps members. It seems probable that warfare in InBo-
. .
nesia cannot be avoided much longer. I am a krained geo-
grapher with a special background In mappbg and a i r photo
bterpretation. I haw travexed throughout the Indonesian
islands and have detailed Amowledge of each of the major
areas and t h e i r resources. Due t o my former compulsory'
association tf!Wr1.'i;heIIndonesfan army WMIe still a student,
it i e quite probable that I would be placed on the front
lines doing reconaissence work in Indanesiat's current
campatgn against Malaysia and the Brftish forces. Asdde
from bvth wZfels and my distasae for t h i s campaign,.my
wSSe i s d l s t r a w t for my safety. No reassurances that
I have been able t o offer her have alleviated her nervous
and upset condition. I have been advised by our doctor
that a proIonged separation under these circumstances woula
endanger my wife's heath and mental: outlook.
In the l i g h t of these considerattons, I ask you t o
please wave the 2-year foreign residence requirement 3 h
OW case.
Aeef,stant RegSml CotKmiaei-r,
Travel ConeraII, B o u t h ~ tRegion
John B. O ' S W , District Director,
lxomvlular, l!awaif

h wardmse wit% OX 212.8(d), om totter of denial ta


subject is forWXdd fm yOW I W ~ W , t~@dtbr
w i t h 8~bjm't'S
file.
mm rn
/'
I'
CENTER FOR
CULTURAL AND TECHNICAL I N T E R C H A N G E
B E T W E E N EAST A N D W E S T
A project oj (he Covernntent oj 160 United Slotcc in roaprro~ion with !be Univcui~y01 HnwK

HONOLULU. HAWAII 66822 CaMe: EASWESCEN

September 27, 1965

Mr. R. E m Soehardi, C u l t u r a l Conoul


KDnsulat Republik Zndoneeis
Sen P r e n c i ~ c o , Celifornfa?

Dear S i r :

This S e t t e r i s t o SoLlof~my l e t t e r t o you of September f 7 , 1965,


wbich I wrote i n response t o your inquiry of September 13 r e g a r d i n g
kk. Lolo Goetor farmer East-Ueot Center grantee, employee o f t h e
I D i r e c t o r o f 'Eo graphy of t h e Zndoneoian Amy.
-A/&/& 6s74- T C / ~ - ~ / . ? ) % L / & S

t h a t he ltes c o m u n i c e t e d t h i s i n t e n t i o n t o t h e M i l i t a r y Attache o f t h e
Embassy of Indonesin i n Washingcon, D.C. He otacee t h a t h i s w i f e fully
i n t e n d s t o r e t u r n t o Xndonesia with him.

If I can provide you w i t h any a d d i t i o n a l i n f o r m a t i o n , plslaoe do n o t


h e s i t a t e t o write.

Reopectfully y o u r s ,

Robert A i t k e n , EvaLuation & Alumni


Liaison Officer -~
I n s t i t u t e 'for S t u d e n t Enterchenge :
East-l?eeC. C e n t e r c ...
;..:.

cc: Dr. i b b c r t G. Zumwinlcle


B f r . Robert I+ooster
.
dImmi&$ration 61 N a t u r a l i o n t i o n Serv2ce
Lolo Soetoro
% pr

C E N T E R FOR
CULTURAL AND TECHNICAL I N T E R C H A N G E
B E T W E E N EAST A N D WEST
A p m f of
~ & h e m a n t of rho UnMed SMer in mo/Jamrbn wWl the Unluenflv of HalwH

HONOLULU. HAWAII 98822 CCIJIO~ SASWE&EN

mwatian ib Alumf liaieon 0fEf.W


Imtitnte for Studoat h
t-
RAP jhl

con Dr. Robert 0. Ztwhhle, I$8outiv@Direotor


Institllre for Bhldmt b r t a r w
7. Conternplatsd data of cloeiogt

- - -- - - --

FOR BVPmPRBOR O
m DATE: 7 - 2 / * 6 ~ ~

iom and M
I ham d sc ead thie case prsoadly with the officer preparimg thie
1 agree vith hie m t a for the f o l l a u i ~reas-:
01 do not agree with hie oosmate for tho reaeone.aet fortb
b s l w and I have directed 'chat eke fol&whg -tiom bd
OPPICE OF TEE EXECUTIVE DIRECTOR
I n s t i t u t e for Student Interchange.
~ast-West center
July 13, 1965
MEMORANDUM

TO: Mr. John P. OIShea, District Director


Immigration and Neturalitation Service, Honolulu, Eawaii
FROM: Robert Zumwinkle. Executive Director
I n s t i t u t e f o r Student Interchange. Bast-West Center
smJBCT: w .
/
/----

I n l o ~oetoro,\onner
&donesia . - Bast-West Center Grantee Prom

.. ..-..---.-.A
._ ,4f28np# -rrh~Z)9#hg
.Mr. Wooster has briefed me on h i s meeting with you today regard-
ing Mr. Soetorols v i s a status. He informs me t h a t you were advised of
the grantee's academic background and of the current s i t u a t i o n with
respect to h i s marriage and request to remain i n t h e United States f o r
an indefinite period. Bs you know, we have received a cable from t h e
Embassy of Indonesia requesting by o f f i c i a l order t h a t Lolo Soetoro, a
c i v i l i a n employee of t h e Indonesian Amy inmediately terminate h i s studies
and return to Djakarta, Indonesia.
Mr. Soetoro came t o the United S t a t e s in September, 1962 from
Indonesia on a J-visa sponsored by the East-West Center. He came t o
participate i n a program designed to insure prompt r e t u r n to his home
country immediately upon the completion of the agreed program of s t u d i e s
.
a t the University of Eawaii. Mr. Soetoro's grant termination date was
June 15. 1964. On June 19. 1964 a t the student's request he was given
permission by the I n s t i t u t e for Student Interchange t o remain i n t h e
United States for p r a c t i c a l trainin8 with Park Associates of &ewaii u n t i l
June 22, 1965. A t t h a t time he was advised t h a t the Center could not hold
h i s return travel beyond t h e June 22, 1965 date. He was informed a l s o
t h a t no further requests t o remain i n the united S t a t e s f o r p r a c t i c a l
t r a i n i n g could be entertained. He was asked t o keep i n touch with t h e
Center and t o take care o f necessary arrangements f o r return t r a v e l e a r l y
i n June of t h i s , year. Since M. Soetoro did. not comply with these
-I
,a

i
instructions, i t can only be assumed that t h i s was an intentional disregard
of Bast-West Center advice. During March of t h i s year, Mr. Soetoro married
i
s United States c i t i z e n who i s currently residing i n Hawaii.
We cannot, i n good conscience, extend Esst-West Center sponsor-
ship of his v i s a o r agree t o h i s r a i n i n g i n the United States. There
i s an agreement i n p r i n c i p l e between the Center and t h e Government of .! '

Indonesia that every e f f o r t w i l l be made to return students a t t h e z :I

completion of t h e i r grants.
5.
z..,;...
0
m O B OP m 3 VLcE-cEMi-
Inaticute for Student XatercbOBe

m-m
'PO: Dr. Zwminkle
PaOnr tlr. Robert Wooeter

SUBJK@r Qiee S m t w of Beet-Weet Center Alumu.9 from tndaaesle,


Mr. Lola Soetoro

On Friday a9ternoon, July 2nd, Mr. Soetoro telephoned sad informed


me that he had gotten h i e 3 visa extended by the Bonolulu tmmigretion and
m t u r a l i w t i w Service. Be informed me also that he had sotten married to
an b e t i c a n pitieen and t h s t hie wife w e oorr ill. He gave hie wLPe'e
illneee ee the reason f o r hie visa extension requeet. I aeked Mr. Soetoro
. t o come in t o eee me on %beeday, July 6. #t. Soetoro arrived a t 3:SO p.m.
and gave me the fallaraing infomation:
1. Addree~: 3326 Oahu Avenue, Bolralulu
Telephone number: 986944
2. On o r a b u t June 4 someone a t WS made an o f f i c i a l entmeion
of hie 3 s i e a t o June 20, 1966. 'Zhere vee no s i ~ g e t u r eon the
card but a notetionB office HB61 379. Mr. Soetoro got thie
externion withmt eoy prior notification o r approval 9- the
East-Weet Cmter. Acwrdiog t o him he getre the Ismigration
officfml the follorving reeeont It wuld he e, eevare hrdehip
on h i s wife i f he were ta, have eo return t o Indoneale tbi8
year. He wan atettied k March (ce~motrecall the exact date)
oe rbie y m r t o an American citieen. Shortly a f t e r they were
married h i e wtfe becema ill end i o still suffering Prom e
etausah a i b e n t ubich my, aocordiug to her pbyeioiao, require
ourgery. When I pressed Mr. Soetoro for more infonmtion
regerdi- t h e maw of the physician, etc., he clafmed t b t
he could not remember exactly.
3. Hr. Soetoro i e still employed by m i i - P a c i f i c Engineere
Sumayere, Xnc., 1649 Kapioleni BLvd., Boom 3, telephone no.
962-151. Be seatee that ehie --me w i l l continue u n t i l
-
June of next year.
4. Mr. S o a t o ~ o ~-ant
e expired on June 15, 1964. A t that Oime
he completed a l l requirements for end reaeived an WL demee
i n hography. A t t h i s time Mr. Soetoro requeeted t b t be be
allorred t o r m i n i n the United States for one yesr for
practical training with Park Aseocfates of Basreti. Ltd. Tbie
r q u e e t we approved end Dr. Eendriakeon signed the appropriete
scraPorandum t o the Foreign Student Advioor a l l o d M~ r. Soetoro
t o remela for practical training u n t i l June 22, 1962 (thie
dete echlslly wae a mieeeke. Should b e read June 19). A t
tht t l a e I m e Program Coordfmtor for the Indonesian
abudmta s o I am Enmiliar with the p a r t i c u l a t a . I handed
t h e student h i s copy of t h e memorandum and signed h i e chock
out sheet (which i n now mieaing from the folder). I adviaed
him t h a t t h e Center could not hold h i a r e t u r n t r a v e l l a t e r
than June 22. 1 9 6 6 one year beyond the o f f i c i a l e x p i r a t i o n
d a t e o f h i e grant. I tmpreeeed him with t h e importance of
keeping i n touch with IS1 and asked him to come t o see me
i n e a r l y June of t h i n year. Approximstely nix month8 l a t e r
P. received a telephone c a l l from Mr. Soetoro explaining t h a t
Park Associates had terminated h i s emplopent because of
lack of work. Be informed me t h a t ha had gotten s Job with
the Hawaii-Pacific Company. 1 advised him t o n o t i f y Iarari-
g r a t i o n iasaedietely of t h i e change and % reminded him t h a t
i t would be neceeacsry f o r hlm t o nee ma e a r l y i n June.
Unfortuneeely, I did not follow-up with a l e t t e r . Thia
advice waa given v e r b a l l y and t h e r e is nothing i n t h e 'folder
t o aubeeantiato thin. 1 did not hear from Mr. Soetoro again
u n t i l J u l y 2. X can only aoaumo t h a t t h i a wlaa an i n t e n t i o n a l
dieregard o f my advice.

5. M r . Soeforo informs me t h a t he has w r i t t e n a l e t t e r t o


Senator Pong r e q u e ~ t i n gan i n d e f i n i t e extension of atany i n
t h e United S t a t e a . Be has received ,a reply from Senator
Poag and has p r a i a e d t o $upply me with a copy a s a w n a s
poaaibie. It took nome urging on my p a r t and P suspect t h a t
be would have preferred not t o give'me a copy.

6. When I explained eo Mr. Soetoro that the East-Went Center


a t i l l r e t a i n e d v i s a aponaorship and a u t h o r i t y and ehnt h i s
r e t u r n t r a v e l option has expired, h e ahowed very Little
concern. Each time P t r i e d t o diacuea ehie with him, he
attemptad to,chanpo t h e aubJect and wadad my d i r e c t questioaa.
I can only assum thnt ha is not e n t i r e l y displeased about t h e
e x p i r a t i o n o f h i s return t i c k e t .

7. Nr. Soetoro is requesting East-Went Center t o mehe a a p e c t a l


exception i n h i e c a m and t o hold h i e r e t u r n t r a v e l f o r
, smother year. o r u n t i l June 22, 1966. He i s a l s o reqoestlng
psrmiaeion t o r-in i n the United S t a t e a f o r t h e asme
period. I( g a t h e r t h a t he intends t o mnke every attempt t o
remain i n d e f i n i t e l y with o r without East-Weat Center approval
although h i s manner ehroughout our interview use p o l i t e and
cordial.

8. Mr. Soetoro would Pike permission f r m us t o work weekends


doing e r a n e l a t i o n for Mre. Witterreens ln M . I do not know
i f he needa bur approval but apparently Mra. Wittermnu haa
seked him t o g e t t h i s permieeion.
I w u l d v e r y much appreciate your advice an t h e a p p r o p r i a t e atepa
ehat should be taken regarding h i s eLatua. Alao it might be a good idea
t o diacuae t h i e p r o b l m with someone a t INS. Pf a atudent can g e t an
extenaioa of v i s a , apparently a8 e a a i l y a# Mr. Soetoro got h i a , t h i s weakensl
our v i s a control conaiderebly and m y give grantees a way around us.

Thank you v e r y much.


P"\ ,0-

URs i'ED STATES DEPARTMENT OF JUSTkbE


Immlgrn~loaand Nitlurelleetlon Seivloa
'

HONOLULU, I-IAWAII RCCKll TO TIIU FILS I(Uua(IR

July 6, 1965 AU 128 294

Mr. & Pks. Lolo Soetoro


3325 Oahu Avenue
Honolulu, Hawaii
Dear Mr. &Mrs. Soetoro:

Please come to the office shown below at the time and place indicated i n connection with an official
matter.

OFFICE by5) 5 bloaclr


~ ~lvd.,nolloldu
LOCATION
Room No. Pimr No.

AND July 19, 1965 at 3:00 ran


. .
. .
ASK FOR ' Travel Control Unit

REASON FOR
APPOINTMENT
; . To be interviewed

BRING WITH YOU evidence of financial status


-

It is important rbst you.kaep chis appointmeat. I f you ere unable to do so, riolify rbis office at once, using
the revers!! side of !his letter, and we will make another appointment for you. Bdng rbis letrer witb you.

Very truly yours,

DISTRICT DIRECTOR
:. . . : : ..... ..: , ............ : ....>... : : . I . :. ;,. .;,;: ~,.:;:.. ::
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s . & K ~ ~ . , ~ $~Bs s p o r and.
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Remarks.
-
' (continuted)

The l e t t e r from the doctor deals only in generalities. It does not


indicate the wife has ever been under the doctor's care or that anp
medical attention w i l l be necessary.
The reasons s e t forth by the applicant do not constitute exceptional
hardship for the United States citizen wife.

-grant Inspector

The applicant and his wife were interviewed on t h i s date. There was no new
evidence presented t o substantiate the claim of hardship. It was revealed
that the wife's mother and father are a t present residing in Honolulu. Up
t o the time of the marriage, she was supported by her parents. She offered
no reaeons why she could not mke her home with them again i n event her
hueband was required t o depart the United States.

&&& H/&+
Frank R. Potter
Tmmigrant Inspector
,_-.,--._--*-.,,.---~.7--.-- --&-.-----'---,
.-

,..
; ax-itiusloti O F STAY GRANTED TO: (dul'i)
APPLICANT FOR
:' EXTENSION DENIED

8 C ISSUED n ExTENIitoN eEcTtoN zno 4


C H ~ N G E O F N O N ~ M M ~ O H ASTATUS
NT $
199UANCEOF 0 S C
..
PQ. en8 W a IOU
33e6oaau-
?
' -=
'b
'-
Dsep? &.
md aa. &etoro:
TORU NlSHlBAYAp M. D.
aosa w u r u u AVENUU
YONOLULU 1 4 W h W U
Wil 29th, 1965

TO WHOM I T MAY OONCEW: Re: h7re.Stenl.e~ Ann D u h m Soetoro


8 . Stanley Ann Dunham Soetoro,
an under graduate student a t t h e University of
Hawaii is faoed w l t b a moat a i f f i o u l t problem--that
of being s e p r a t e d from her hwbana Lolo Soetoro, an
InBoneeim whose visa t o the United S t a t e s expiEee
i n June 1965.
I n t e r n a l problem i n InBonesla
make it alntost impoeelble t o go t h e r e even i f it
were possible finanoially t o do so--and it i s not.
Other oomiderations would
make it mandatory tht t h e oouple be separated f o r
a very long perioa of time.
Medloally, I f e e l that suoh
a s e r a t i o n w u l d oause undue hardship an8
E"
emot onal s t r a i n were it t o happen, and ahp help
t o a l l e v i a t e t h e s i t u a t i o n would be of g r e a t
eervioe t o her.

Sinoerelg,
. ..,~
: PRBVIOUOLV BXIQNnSn
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OR' I
"
T T E N S l O M OF W A Y
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n EXTENSION DENIED
0 S C ISSUED 0 "TENSION 0SeoTloN 2 4 8
0 V/D QRANTED W/O 0 CHANOE OP NONIMMIQRANT STATUS
ISSUANCE OP OSC
STATUS ADJUSTED TO THLT OP PERMANENT REBIDBNT ON, IDA-)

...
3.n.o (RN I-I.==) IPI.LPS.S.O~.IM.BIIO REPORT OF ACTION

--- ----
NDNIMMIQRANT
IYUIORATION AND NAIURILIZATION EPRVlCE
Nemo t o f i l e : hl412829L

I n accordance with t h e i n s t r u c t i o n s with t h e memo r e c e i v e d from a c t i n g DDD


Fujiwara Flr, and fdrs Soetoro were r e interviewed on t h i s d a t e . The follo$ng
information was obh~iined,

11. Mr. Soetero i s now employed a t Havwiii P a c i f i c Engineers and Surveyors,


inc. 1649 Kqpiolani Blvd. S u i t e #3, Honolulu, Hawaii. His r a t e o f pay i s
Wftr %+00 and h i s t a k e home pay f o r two weeks wighout overtime i s $133.03.
2. They have some outstanding b i l l s . A Dentist b i l l f o r Mr. Soetero f o r
$81.0. The d e n t i s t has a l s o t o l d him he would have t o have 4 wisdom
t e e t h e x t r a c t e d , 0therv:ise he i s good physical. condition, They a l s o pre-
sented a telephone b i l l which showed one month i n a r r e a r s i n t h e mount
of $18.84. Their r e n t amounts t o $65.00 per month which i s nominal f o r t h i s
K E E area. They pay an e l e c t r i c b i l l of l e s s than $5.03 p e r month t o t h e i r land
ihrond lord.

3. They own a 1963 Chevrolet Corvair a g a i n s t which t h e r e i s no l e i n . His


uncle i n Indonesia gave him t h e c a r and he is paying money as he can. He
has t o send t h e money with persons returning t o Indonesia from Honolulu b ~ c a u s e
t o send money through t h e mail would bs t o a r i s l r y i n Indonesia,

5, As a d e t e m n t t o t h e i r f i n a n c i a l condition a f f e c t i n g h i s a b i l i t y t o
support h i s wife from Indonesia he s t a t e s t h a t t h e v a l u e o f t h e Indonesian
Rupiah has d e t i o r a t e d from 4,000 t o 1 t o 10,000 t o 1.

Since t h e first i n t e r v i e w t h e r e have bsen placed i n t h e f i l e two memos from


East kiest Center i n d i c a t a n g t h a t the Government of Indonesia i s i n t e r e s t e d i n
having t h i s s t u d e n t r e t u r n t o h i s homeland. Aoopy of a c a b l e i s s u i n g an o r d e r
from t h e Indonesian Embassy f o r t h e s u b j e c t ' s r e t u r n was included vrith one of
these memos.