State of Hawaii v. Trump

Filing 294

Declaration of Neal K. Katyal in Support of #293 Plaintiff's Emergency MOTION to Clarify Scope of Preliminary Injunction re #291 Preliminary Injunction, . (Attachments: #1 Exhibit Ex. A, #2 Exhibit Ex. B, #3 Exhibit Ex. C, #4 Exhibit Ex. D, #5 Exhibit Ex. E, #6 Certificate of Service)(Katyal, Neal) Modified on 6/30/2017 (emt, ).

RECEPTION AND PLACEMENT PROGRAM ASSURANCE FORM

Page 1 of 1

CWS

ASSURANCE
Placement Code: 0-0
DATE:

File ID Number:

Present Location:

The following persons have been accepted for resettlement under our auspices:
Name

Alien Number

DOB

MC

Sex

POB

1

Affiliate:

Local Sponsor:

Relative (if applicable):

Phone:

Home Phone:

FAX:

Work Phone:

Airport of Final Destination:
Placement Location:
Special Instructions:

Other Bio Information:

Cross Reference:

The affiliate has an agreement with the national agency to
provide, or ensure the provision of, reception and placement
services to the above named refugee(s) in accordance with
the U.S. Department of State Cooperative Agreement.

Signature:
Authorized Agency
Representative

EXHIBIT E
REFUGEE PROCESSING CENTER, 1401 NORTH WILSON BLVD., SUITE 700, ARLINGTON VIRGINIA 22209