[Code of Federal Regulations] [Title 22, Volume 1] [Revised as of April 1, 2001] From the U.S. Government Printing Office via GPO Access [CITE: 22CFR62.90] [Page 313-317] TITLE 22--FOREIGN RELATIONS CHAPTER I--DEPARTMENT OF STATE PART 62--EXCHANGE VISITOR PROGRAM--Table of Contents Subpart H--Fees Sec. 62.90 Fees. (a) Remittances. Fees prescribed within the framework of 31 U.S.C. 9701 shall be submitted as directed by the Department and shall be in the amount prescribed by law or regulation. Remittances must be drawn on a bank or other institution located in the United States and be payable in United States currency and shall be made payable to the ``Department of State.'' A charge of $25.00 will be imposed if a check in payment of a fee is not honored by the bank on which it is drawn. If an applicant is residing outside the United States at the time of application, remittance may be made by a bank international money order or a foreign draft drawn on an institution in the United States, and payable to the Department of State in United States currency. (b) Amounts of fees. The following fees are prescribed: (1) Request for program extension--$198. (2) Request for change of program category--$198. (3) Request for reinstatement--$198. (4) Request for program designation--$799. (5) Request for non-routine handling of an IAP-66 Form Request--$43. [65 FR 20083, Apr. 14, 2000] Appendix A to Part 62--Certification of Responsible Officers and Sponsors In accordance with the requirement at Sec. 514.5(c)(6), the text of the certifications shall read as follows: 1. Responsible Officers and Alternate Responsible Officers I hereby certify that I am the responsible officer (or alternate responsible officer, specify) for exchange visitor program number ________, and that I am a United States citizen or permanent resident. I understand that the Department of State may request supporting documentation as to my citizenship or permanent residence at any time and that I must supply such documentation when and as requested. (Name of organization) agrees that my inability to substantiate the representation of citizenship or permanent residence made in this certification will result in the immediate withdrawal of its designation and the immediate return of or accounting for all Forms IAP-66 transferred to it. [[Page 314]] Signed in ink by _______________________________________________________________________ (Name) _______________________________________________________________________ (Title) Witness:________________________________________________________________ This ____________ day of ____________, 19____. Subscribed and sworn to before me this ____________ day of ____________, 19____. _______________________________________________________________________ Notary Public 2. Sponsors. I hereby certify that I am the chief executive officer of (Name of Organization) with the title of (specify); that I am authorized to sign this certification and bind (Name of Organization). I further certify that (Name of Organization) is a citizen of the United States as that term is defined at 22 CFR Sec. 514.2. (Name of Organization) agrees that inability to substantiate the representation of citizenship made in this certification will result in the immediate withdrawal of its designation and the immediate return of or accounting for all Forms IAP-66 transferred to it. Signed in ink by _______________________________________________________________________ (Name) _______________________________________________________________________ (Title) Attestation/Witness:____________________________________________________ This ____________ day of ____________, 19____. Subscribed and sworn to before me this ____________ day of ____________, 19____. _______________________________________________________________________ Notary Public Appendix B to Part 62--Exchange Visitor Program Services, Exchange- Visitor Program Application Form Approved OMB_______________________________________________________ Serial No.______________________________________________________________ _______________________________________________________________________ 1. Name and Address of Sponsoring Organization _______________________________________________________________________ 2. Name and Title of Responsible Officer _______________________________________________________________________ Telephone Number _______________________________________________________________________ 3. Name and Title of Alternate Responsible OfficerPRTPAGE P='314' _______________________________________________________________________ Telephone Number _______________________________________________________________________ 4. Type of Application (check one) New ______ Re-Apply ______ Re-Designation__________________________________________________________ Section I--Program Participant Data (For Definition & Length of Stay See 22 CFR ______) 5. Participation by Category (indicate total no. and approximate duration of stay in each category) A. Student______________________________________________________________ B. Teacher______________________________________________________________ C. Professor____________________________________________________________ D. Researcher___________________________________________________________ E. Short-term Scholar___________________________________________________ F. Specialist___________________________________________________________ G. Trainee______________________________________________________________ 1. Specialty__________________________________________________________ 2. Nonspecialty_______________________________________________________ H. Int'l Visitor________________________________________________________ I. Gov't Visitor________________________________________________________ J. Physicians___________________________________________________________ K. Camp Cnslr___________________________________________________________ L. Sumr/Wk/Trvl_________________________________________________________ _______________________________________________________________________ 6. Method Of Selection _______________________________________________________________________ 7. Arrangements for Financial Support of Exchange Visitor while in the U.S. _______________________________________________________________________ Section II--Program Data 8. Outline of Proposed Activities (If training, See Reverse) _______________________________________________________________________ 9. Arrangements for Supervision and Direction _______________________________________________________________________ 10. Purpose of Objective _______________________________________________________________________ 11. Role of other Organizations Associated with Program (if any) _______________________________________________________________________ Section III--Certification 12. Citizenship Certification of Organization and Responsible Officer (see reverse) 13. I certify that information given in this application is true to the best of my knowledge and belief and that I have completed appropriate information on reverse of this form. _______________________________________________________________________ Signature of Responsible Officer _______________________________________________________________________ Date Instructions for All Programs If additional space is needed in supplying answers to any questions, please use continuation sheets on plain white paper. 1-3. Names and addresses of organization and telephone numbers. 4. Select type of application. 5. Select appropriate categories (see 22 CFR prior to filling out this data). 6-7. Complete information on program sponsor. 8-11. Complete information on program. [[Page 315]] IF TRAINING PROGRAM, identify appropriate fields: 01--Arts & Culture; 02--Information Media and Communications; 03--Education; 04-- Business and Commercial; 05--Banking and Financial; 06--Aviation; 07-- Science, Mechanical and Industrial; 08--Construction and Building Trades; 09--Agricultural; 10--Public Administration; 11--Training, Other Reapplication and Redesignation: If your organization is making reapplication as an exchange visitor program, or applying for redesignation under 22 CFR ____, please certify to the following: I hereby certify that as an officer of the organization making application for an exchange program under 22 CFR ____ or 22 CFR ____ that the following documents which have been submitted to the Department of State, Exchange Visitor Program Services, remain in effect and not altered in any way: (1) Legal status as a corporation such as Articles of Incorporation and By Laws. Provide dates and state of both:________ (2) Accreditation. Provide date, type of accreditation, and State of accreditation:______ (3) Evidence of Licensure. Provide date, type of license, and state of licensure:______. (4) Authorization of governing body authorizing application. Please provide date of such authorization and authorizing body:____________. (5) Activities in which the organization has been engaged have not changed since application dated:______. (6) Citizenship. Provide the date of compliance with citizenship requirements:________. If citizenship compliance is not current, please complete the following: Organization: I hereby certify that I am an officer of ________ with the title of ________; that I am authorized by the (Board of Directors, Trustees, etc.) to sign this certification and bind ______; and that a true copy certified by the (Board of Directors, Trustees, etc.) of such authorization is attached. I further certify that ______ is a citizen of the United States as that term is defined at 22 CFR 514.1. Responsible Officer or Alternate Responsible Officer: I hereby certify that I am the responsible officer (or alternate responsible officer) for ______, and that I am a citizen of the United States (or a person lawfully admitted to the United States for permanent residence. ________ agrees that my inability to substantiate my citizenship or status as a permanent resident will result in the immediate withdrawal of its designation and immediate return of or accounting for all IAP-66 forms transferred to it. Certification as to (1)-(6) Requirements: I understand that false certification may subject me to criminal prosecution under 18 U.S.C. 1001, which reads: ``Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies, conceals or covers up by any trick, scheme or device a material fact or makes any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than five years, or both.'' Signed in ink by (Name)_________________________________________________ Title___________________________________________________________________ Subscribed and sworn to before me this ______ day of ______, 19____. Notary Public Department of State Use Only Type of program:________________________________________________________ Subtype if applicable:__________________________________________________ No. Forms IAP-66:_______________________________________________________ Categories:_____________________________________________________________ Please return form to: Exchange Visitor Program Services-GC/V, Department of State, Washington, DC 20547 Note: Public reporting burden for this collection of information (Paperwork Reduction Project: OMB No. 3116-0011) is estimated to average ____ minutes/hours per response, including time for reviewing instructions, researching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of State Clearance Officer, M/ ASP, Department of State, 301 4th Street, SW., Washington, DC 20547; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. Appendix C to Part 62--Update of Information on Exchange-Visitor Program Sponsor Please amend the Department of State records for Exchange-Visitor Program Number__________________________________________________________ assigned to ________________ as follows: (Name of institution/organization) 1. Change the name of the Program Sponsor from the above to_______________________________________________________ _______________________________________________________________________ 2. Change the address of the Program Sponsor From:___________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ (city) (state) (zip) To: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ [[Page 316]] (city) (state) (zip) 3. ( ) Change the telephone number from ________ to ________ ( ) Change the fax number from ________ to ________ 4. ( ) Change the name of the Responsible Officer of the above program from ________ to ________ 5. a. Delete the following Alternate Responsible Officer: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ 5. b. Add the following Alternate Responsible Officer: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ (Citizenship is required for all Responsible and Alternate Responsible Officers-See Reverse) 6. ( ) Send ______ (indicate number) IAP-66 forms. (PLEASE ALLOW FOUR TO SIX WEEKS FOR RESPONSE AND REMEMBER TO SUBMIT THE ANNUAL REPORT) 7. ( ) Send ______ copies of this form. 8. ( ) Send ______ copies of Codes for Educational and Cultural Exchange. 9. ( ) Cancel the above named Exchange Visitor Program. _______________________________________________________________________ (Signature of Responsible or Alternate Responsible Officer) _______________________________________________________________________ (Date) _______________________________________________________________________ (Title of Signing Officer) Appendix D to Part 62--Annual Report--Exchange Visitor Program Services (GC/V), Department of State, Washington, DC 20547, (202-401-7964) Exchange Visitor Program No. ______ Reporting Period ______ Provide Range of Forms IAP-66 Documents Covered by this Report (______-______). (a) STATISTICAL REPORT (1) ACTIVITY BY CATEGORY Number Professor................................................... ________ Research Scholar............................................ ________ Short-term Scholar.......................................... ________ Trainee..................................................... ________ Student (College and University)............................ ________ Student (Practical Trainee)................................. ________ Teacher..................................................... ________ Student (Secondary)......................................... ________ Specialists................................................. ________ Physicians.................................................. ________ International Visitors...................................... ________ Government Visitors......................................... ________ Camp Counselors............................................. ________ ----------- Total................................................... ________ =========== (2) Forms IAP-66 Reconciliation (i) Number of Forms IAP-66 voided or otherwise not used by participant ________....................................... (ii) Number of Forms IAP-66 issued for dependents ________.. (iii) Number of Forms IAP-66 currently on hand ________..... (b) PROGRAM EVALUATION On a separate sheet, please provide a brief narrative report on program activity, difficulties encountered and their resolution, program transfers, anticipated growth and the proposed new activity, cross- cultural activities, as well as the reciprocal component of the program. I, The Responsible Officer of the program indicated above, certify that we have complied with the insurance requirement (22 CFR 514.14). I also certify that the information contained in this report is complete and correct to the best of my knowledge and belief. _______________________________________________________________________ Responsible Officer (signed) Date____________________________________________________________________ _______________________________________________________________________ Name and address of sponsoring institution Appendix E to Part 62--Unskilled Occupations For purposes of 22 CFR 514.22(c)(1), the following are considered to be ``unskilled occupations'': (1) Assemblers (2) Attendants, Parking Lot (3) Attendants (Service Workers such as Personal Services Attendants, Amusement and Recreation Service Attendants) (4) Automobile Service Station Attendants (5) Bartenders (6) Bookkeepers (7) Caretakers (8) Cashiers (9) Charworkers and Cleaners (10) Chauffeurs and Taxicab Drivers (11) Cleaners, Hotel and Motel (12) Clerks, General (13) Clerks, Hotel (14) Clerks and Checkers, Grocery Stores (15) Clerk Typist (16) Cooks, Short Order (17) Counter and Fountain Workers (18) Dining Room Attendants (19) Electric Truck Operators (20) Elevator Operators (21) Floorworkers [[Page 317]] (22) Groundskeepers (23) Guards (24) Helpers, any industry (25) Hotel Cleaners (26) Household Domestic Service Workers (27) Housekeepers (28) Janitors (29) Key Punch Operators (30) Kitchen Workers (31) Laborers, Common (32) Laborers, Farm (33) Laborers, Mine (34) Loopers and Toppers (35) Material Handlers (36) Nurses' Aides and Orderlies (37) Packers, Markers, Bottlers and Related (38) Porters (39) Receptionists (40) Sailors and Deck Hands (41) Sales Clerks, General (42) Sewing Machine Operators and Handstitchers (43) Stock Room and Warehouse Workers (44) Streetcar and Bus Conductors (45) Telephone Operators (46) Truck Drivers and Tractor Drivers (47) Typist, Lesser Skilled (48) Ushers, Recreation and Amusement (49) Yard Workers