WPC  77WPC >?}Ag?@[?Os?IM@e=<$^oɲZ87>L  (  (Untitled)'3,, , ,   UB ) 3    *    d +    d ,    d /0ghjklmnopqrstuvwxyz{|}~P* * c:\inf42\forms\ad121.wpf c:\inf41\phuong2\ad121.wpfUS&& &&   >?f eh Terminal 1 ! d !  d      Terminal eb Arial " ! 2     d    Arial ?Ad A{?z jV c:\inf41\database\ AD121.DBFhistory   i%Date     h DATE i(OfcPass      h OFCPASS  i(RevPass      h REVPASS  i(DipPass      h DIPPASS  i'DeDate     h DEDATE i'ReDate     h REDATE i(ToAddr1  6   h TOADDR16 i(ToAddr2  6   h TOADDR26 i(ToAddr3  6   h TOADDR36 i&TName  K   h TNAMEK i&Title  K   h TITLEK i'NewPos      h NEWPOS  i$Rep      h REP  i(RepName  ,   h REPNAME, i$TDY      h TDY  i%Ctry      h CTRY  i%Trip      h TRIP  i(T_1[A2]     h T_1_A2_ i(T_1[B2]     h T_1_B2_ i(T_1[C2]  #   h T_1_C2_# i(T_1[D2]     h T_1_D2_ i(T_1[A3]     h T_1_A3_ i(T_1[B3]     h T_1_B3_  i(T_1[C3]  #   h T_1_C3_ # i(T_1[D3]     h T_1_D3_  i(T_1[A4]     h T_1_A4_  i(T_1[B4]     h T_1_B4_  i(T_1[C4]  #   h T_1_C4_# i(T_1[D4]     h T_1_D4_ i(T_1[A5]     h T_1_A5_ i(T_1[B5]     h T_1_B5_ i(T_1[C5]  #   h T_1_C5_# i(T_1[D5] !    h T_1_D5_ i(T_1[A6] "    h T_1_A6_ i(T_1[B6] #    h T_1_B6_ i(T_1[C6] $ #   h T_1_C6_# i(T_1[D6] %    h T_1_D6_ i(T_1[A7] &    h T_1_A7_ i(T_1[B7] '    h T_1_B7_ i(T_1[C7] ( #   h T_1_C7_# i(T_1[D7] )    h T_1_D7_ i(T_1[A8] *    h T_1_A8_ i(T_1[B8] +    h T_1_B8_ i(T_1[C8] , #   h T_1_C8_# i(T_1[D8] -    h T_1_D8_ i(T_1[A9] .    h T_1_A9_  i(T_1[B9]! /    h T_1_B9_! i(T_1[C9]" 0 #   h T_1_C9_"# i(T_1[D9]# 1    h T_1_D9_# i'Remark  2    h REMARK  i$Req 3 =   h REQ= i%Sign 4 =   h SIGN= ?@d @}?OX & U.S. Department of Agriculture  & Foreign Agricultural Service % !"#      n                       P  &&    XR& & Passport Request  &    (Submit original and three copies to FAS) % !"#      x                       P  &&    R }&  1. Date Date!"-./5*67%89:%;>?@ABCG                         P #      $      ' =  Y@$.,! *  < <& = &     2@HASVALUE (Date) and #UPDATONLY    Date  ~      7@datevalue (@datetext (Date, "%2-%1-%5"))   Date   %2-%1-%5  "  #  4@VALUE (@DATETEXT (Date,"%5"))<=29   Date   %5  "  x         p@SETVALUE (Date, @DATEVALUE (@CONCAT (@DATETEXT (Date,"%2-%1"),"-20",@DATETEXT (Date,"%5"))),TRUE)   Date   Date   %2-%1  "   -20   Date   %5  "      #        X }&  2. Action Requested *% !"#                             P  <&     4 }& Issuance of Official Passport   OfcPass#$%,&'()+,-.                             P   !  * `  1    2      3     ~4 }& Revalidation of passport   RevPass#$%,&'()+,-.                             P   !  * `  1    2      3      }& Issuance of Diplomatic Passport   DipPass#$%>&'()+,-.                             P   !  * `  1    2      3     mx }&  3. Date of Departure from U.S.A. DeDate!"-./5*67%89:%;>?@ABCG                         P #      $      ' =  Y@$.,! *  < <& = &     4@HASVALUE (DeDate) and #UPDATONLY    DeDate  ~      9@datevalue (@datetext (DeDate, "%2-%1-%5"))   DeDate   %2-%1-%5  "  #  6@VALUE (@DATETEXT (DeDate,"%5"))<=29   DeDate   %5  "  x         v@SETVALUE (DeDate, @DATEVALUE (@CONCAT (@DATETEXT (DeDate,"%2-%1"),"-20",@DATETEXT (DeDate,"%5"))),TRUE)   DeDate   DeDate   %2-%1  "   -20   DeDate   %5  "      #       h }&  4. Date of Return to U.S.A. ReDate!"- ./5*6 7%89:%;>?@ABCG                         P #      $      ' =  Y@$.,! *  < <& = &     4@HASVALUE (ReDate) and #UPDATONLY    ReDate  ~      9@datevalue (@datetext (ReDate, "%2-%1-%5"))   ReDate   %2-%1-%5  "  #  6@VALUE (@DATETEXT (ReDate,"%5"))<=29   ReDate   %5  "  x         v@SETVALUE (ReDate, @DATEVALUE (@CONCAT (@DATETEXT (ReDate,"%2-%1"),"-20",@DATETEXT (ReDate,"%5"))),TRUE)   ReDate   ReDate   %2-%1  "   -20   ReDate   %5  "      #       nXx,  }&  To   !"#                             P  &    ]XZ# }&  5. Name of TravelerZ# TName! "-./56 7K89:K;>?@ABCG                         P #      $      ' K  Y@$.,! *  < & = &     ]X( Z# }&  6. Title and AgencyZ# Title! "-./56 7K89:K;>?@ABCG                         P #      $      ' K  Y@$.,! *  < & = &     X Z# }&  7. Kind of Overseas Assignment K !"#                             P  &     N  }& New position   NewPos #$%&' ()+,-.                             P   !  * `  1   2      3      N  }& Replacement for (name)   Rep #$%&'()+,-.                             P   !  * `  1   2      3     7N (  RepName!"-./5&6789:;>?@ABCG                         P #      $      ' ,  Y@$.,! *  < && = &&     N   }& TDY   TDY#$%=&'()+,-.                             P   !  * `  1   2      3     cXH Z# }&  8. Countries to be visitedZ# Ctry!"-./567K89:K;>?@ABCG                         P #      $      '  K  Y@$.,! *  < & = &     vX0Z#  }&  9. Purpose of Trip (for each country visited)Z# Trip!"-./567K89:K;>?@ABCG                         P #      $      '  K  Y@$.,! *  < & = &     X Z# } 10. Dependents to Accompany Traveler $K !"#                             P  &     XZ#T 1  T_1#$(1),-%.K/ 012456789                                    P ! "9$%&')*                      Y@$.,!  ( &&  3 &&    A     A     A     A     A     A     A     A     A     ?T     ?@     ?     ?@     AT  }& Name"$%&')*                       Y@$.,!  ( &&     I@ }& Relationship"$% &')*                       Y@$.,!  ( &&     ~  }&  Place of Birth  }& (City and State or Country)"$%&')*                       Y@$.,!  ( &&     r@ }& Date of Birth  }& (Month, Day & Year)" $% &')*                       Y@$.,!  ( &&     *T "!$%&')*                      Y@$.,!  ( &&     *@""$% &')*                      Y@$.,!  ( &&     * "#$%&')*                    #  Y@$.,!,  ( &&     ,@"$$% &')*                      @$.,!  ( &&     5@HASVALUE (T_1[D2]) and #UPDATONLY   T_1  ~      :@datevalue (@datetext (T_1[D2], "%2-%1-%5"))  T_1   %2-%1-%5  "  #  7@VALUE (@DATETEXT (T_1[D2],"%5"))<=29  T_1   %5  "  x         y@SETVALUE (T_1[D2], @DATEVALUE (@CONCAT (@DATETEXT (T_1[D2],"%2-%1"),"-20",@DATETEXT (T_1[D2],"%5"))),TRUE)  T_1  T_1   %2-%1  "   -20  T_1   %5  "      #       *T "%$%&')*                      Y@$.,!  ( &&     *@ "&$% &')*                      Y@$.,!  ( &&     *  "'$%&')*                    #  Y@$.,!,  ( &&     ?$%&')*                      Y@$.,!  ( &&     *@"?$% &')*                      Y@$.,!  ( &&     * "@$%&')*                    #  Y@$.,!,  ( &&     ,@"A$% &')*                      @$.,!  ( &&     5@HASVALUE (T_1[D7]) and #UPDATONLY   T_1  ~      :@datevalue (@datetext (T_1[D7], "%2-%1-%5"))  T_1   %2-%1-%5  "  #  7@VALUE (@DATETEXT (T_1[D7],"%5"))<=29  T_1   %5  "  x         y@SETVALUE (T_1[D7], @DATEVALUE (@CONCAT (@DATETEXT (T_1[D7],"%2-%1"),"-20",@DATETEXT (T_1[D7],"%5"))),TRUE)  T_1  T_1   %2-%1  "   -20  T_1   %5  "      #       *T "B$%&')*                      Y@$.,!  ( &&     *@"C$% &')*                      Y@$.,!  ( &&     * "D$%&')*                    #  Y@$.,!,  ( &&     ,@"E$% &')*                      @$.,!  ( &&     5@HASVALUE (T_1[D8]) and #UPDATONLY   T_1  ~      :@datevalue (@datetext (T_1[D8], "%2-%1-%5"))  T_1   %2-%1-%5  "  #  7@VALUE (@DATETEXT (T_1[D8],"%5"))<=29  T_1   %5  "  x         y@SETVALUE (T_1[D8], @DATEVALUE (@CONCAT (@DATETEXT (T_1[D8],"%2-%1"),"-20",@DATETEXT (T_1[D8],"%5"))),TRUE)  T_1  T_1   %2-%1  "   -20  T_1   %5  "      #       *T  "F$%&')*                      Y@$.,!  ( &&     *@!"G$% &')*                      Y@$.,!  ( &&     * ""H$%&')*                    #  Y@$.,!,  ( &&     ,@#"I$% &')*                      @$.,!  ( &&     5@HASVALUE (T_1[D9]) and #UPDATONLY   T_1#  ~      :@datevalue (@datetext (T_1[D9], "%2-%1-%5"))  T_1#   %2-%1-%5  "  #  7@VALUE (@DATETEXT (T_1[D9],"%5"))<=29  T_1#   %5  "  x         y@SETVALUE (T_1[D9], @DATEVALUE (@CONCAT (@DATETEXT (T_1[D9],"%2-%1"),"-20",@DATETEXT (T_1[D9],"%5"))),TRUE)  T_1#  T_1#   %2-%1  "   -20  T_1#   %5  "      #       VX$Z# }&  11. RemarksZ# Remark!"-2./56/7K8 9:K;>?@ABCG                         P #      $      '  K  Y@$.,! *  < & = &     XP-X }&  12. Requested by (title)   & Assistant Administrator, ManagementReq!"-4./56:7%89:%;>?@ABCFG                         P #      $      ' =  Y@$.,! *  < & = &&     WP-X }&  12A. Signature Sign!"-5./5*6:7%89:%;>?@ABCG                         P #      $      ' =  Y@$.,! *  < <& = <&     X/Z#,6 q&<  Form AD-121 Rev. 2-90  =K !"#                             P  &    X/ 7 d This form was electronically produced by Elite Federal Forms, Inc. = !"#                             P  &    ]L   & Director, Passport OfficeToAddr1!"-J./5 67!89:;>?@ABCFG                         P #      $      ' 6  Y@$.,! *  < && = &&     WL   & Department of StateToAddr2!"-K./5 67!89:;>?@ABCFG                         P #      $      ' 6  Y@$.,! *  < && = &&     ZL   & Washington, D.C. 20524ToAddr3! "-L./5 6 7!89:;>?@ABCFG                         P #      $      ' 6  Y@$.,! *  < && = &&     ?:=de =<$defg <^o elite10.DLL IVALID FILLER This form was Designed by Elite Federal Forms and requires the Elite/Novell Filler! Call 410-647-9691 for more information. elite10.COM IVALID FILLER This form was Designed by Elite Federal Forms and requires the Elite/Novell Filler! Call 410-647-9691 for more information. WPIN$ELITE10FunctionSet,4.1 ^=Z\W