INSTRUCTIONS FOR AND CERTIFICATION BY THE ALIEN BENEFICIARY NAMED ON PAGE 1 OF THIS FORM: Read this page and sign the Exchange Visitor Certification block on the bottom of pagel and prior to presentation to a United States Consular or Immigration Official, 1. L understand that the following conditions are applicable to exchange visitors: (a) TWO-YEAR HOME.COUNTRY PHYSICAL PRESENCE REQUIREMENT SECTION 212) OF THE IMMIGRATION AND NATIONALITY ACT AND PL 94-18, ASAMENDED} RULE: Exchange vistors whose porns ar Siapeedin whole tin pu decency by cite ti goverment oy he US Gove ae oe esd in ir Iame-ouny fe? yea following cement propa eit eye pe omit stn, tera ke stun, ecopany eae ue Litewise exchange tors ae nq lati iS spy ths hme Cums pao he “aang Visor Ss ir ey wil be see tne moaear hr cumsy ves rqurenet The que sce splat oan pci cag he Ute Stes eee rae medal ses wig. ‘TheUS.Beparmeno See renee igh ome tes! deeming 3120 NOTE: MARRIAGE TO A US. CITIZEN OR LEGAL PERMANENT RESIDENT. OR BIRTH OF A CHILD IN THE UNITED STATES DOES NOT REMOVE THUS REQUIREMENT. (2) Extension o StyProgram Tanstrs: coop Foon D.2019 is id nk apy or pyran een po as bie om er wih (6) Lanta of tay, STUDENTS ng my lefty on ge fg iin node pan 24 mens Sas ‘neni ening my be approved by the sponser prod nto exceed 6 month, SECONDARY STUDENTS 10 aces year, TRAMEES <8 monty. AUEN PHYSICIAN. he ime ply eed occ he media cy toler bd? yea wh he pesblty tees apponed Be US Diparnst {Sie GOVERNMENT VSTOR po 18 mond “CAMP COUNSELON opt ont SUMMER WORNTRAVEL pot ment AUPAR tr; INTERN: pio? (a) Documentation Required for Admisslon’Readmission as an Exchange Visitor: Tobe cee sdgon othe Ud Sens, an exchange vst mst pes he fellowing nt th prety (ava nenmnagrant vin, est exc om hone! vs eqatenens (Japp al ler mons beyond he smal peed oF ‘nuon tls chenys fom psoas) petted Form DS-20 eh 0 haa ink mabe ened by ees vs frelon ‘Note pvt revouay ahmed ay’ Exchange vas pried oe eed td at sta eon 9 ona unr de fe on ‘nail te ton ttm (eon Son pe orm (0) Change of Visa Stats: Exchange icant penn) are expec oleae ene Sites pon option of ipa cstv, Echags visits who te ‘set te eer homeouey pyc eience tenet cb change i ttn nse the Une Ses an ter oun xe tna hat of oleae employe aoe ovement) abr fe any een oe tp of la on (9 insurance: tschonge vistors we repre tw have meal nce ff heme i ay ssmpaying ot mn cic ve Gr tet of ir ‘etching progam Ats mi, nse coven sal eae meen teat US $8000 perpen peace laer, 2)opaan of reacsn ie foun of US 5150" and) expenses unc eal evasauon tc sano 3310000 A ply seedless al at ‘Ewe exceeds US 380 per scent or ne vd ma ewer sade pedi the FacatgeVntr gran reps, 9 CPA Pao Fd som ‘ourpopasRepoate Otero eats Repsie fic fee tom on pape of i fam) 2. EXCHANGE VISITOR CERTIFICATION: have read and understand the foregoing, including the Two-Year Home-Country Physical Presence ‘Requirement, and agree to comply with the Exchange Visitor Program regulations, as amended (22 CFR Part 62). eeity that all the information on ‘the Form DS-2019 is true and correct tothe best of my Knowledge. I agree that Iwill maintain compliance with the insurance regulations as specified Iuding maintaining health insurance coverage for myself and my J-2 dependents throughout my J-1 program, 1 understand that ity to maintain my exchange visitor status. For the purposes of 20 U.S.C. 1232g and 22 CFR 62, 1 authorize the US. Department of State-designated sponsor and any educational institution named on the Form DS-2019 to release information tothe US. Department of State relating to compliance with Exchange Visitor Program regulations. NOTICE TO ALL EXCHANGE VISITORS To fucilitate your readmission tothe United States ater a visit in another country other than a contiguous teritory or adjacent islands, you should have the Responsible Officer or Alternate Responsible Oificer of your sponsoring organization indicate on the TRAVEL VALIDATION BY RESPONSIBLE OFFICER o Alternate Responsible Officer section ofthe Form DS-2019 that you continue to be in good Standing, ‘The signature ofthe Responsible Officer or the Altemate Responsible Officer on the Form DS-2019 is valid for upto one year* or until the end date in item 3 ‘on page I ofthis Form, or othe validation date authorized by the Responsible Officer, whichever occurs sooner "EXCEPT: Maximum validation period is upto 6 months for Short-term Scholars and 4 months for Camp Counselors and Summer Work/Travel, * Under the Mutual Educatonal and Cultural Exchange Act of 196, as amended, the US Departnent of State hasbeen delegated he authority to designate Exchange Visitor Programs for US. Government agencies, nd for public and private educttonal a ula exchange ganizations. The informations sed by Exchange Visitor Program sponsors ‘o sppropitelywenify an individual secking to emer the United Sates as an exchange visitor The completed Tom is sent the prospective exchange visor abroad, iho takes tothe US. Consulate (Embassy) 1 secure an exchange Visor (+, 2) visa. Responses re mandlery An Agency of organization may not conto sponsor, an the respondent 'snot required to respond to aeollecton af infrmatin unless plays valid OMB contol number Publi reporting burden fo this olecton of infrmation ie etimate average 43 minutes por espose, including he une fr reviewing instructions, researching existing dats sources. ghering nd maintaining the data nesded, completing and reviewing the collection of information. Send comments regarding ths burden estimate or any eer aspect of thi cllection of mnfermation, lating suggestions fr reducing his burdento- US Department of State, AASSIDIR, Washington, D.C 20520,