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![handle is hein.jfk/jfkarch19946 and id is 1 raw text is:
CIA EOMC R2IN PROGRM
Z:-l ,ssr An LstVr
CoNAr SECTION
PLEASE PRINT AR TaPL i an C. *QrIkh No.
VISA OR TOURIST CARD .OPPLTTrN A TR-%VL TO<FL S'OR
FULL NAME CITIZENSiP
PLACE AND DATE OF BIRTH
PROFESSION taRITALSTATriUsamle
RELIGION RACE -:hile SEX mil1a
PURPOSE OF TRIP a LLNGTH OF DESIRED STAY-4am -
DATE OF. EXPECTED ..RRIVAL IN SL SALV.'JOR
PRESENT ADDRESS
NAME OF MINORS TRAVELING WITH APPLICANT ao
NAME, KINSHIP AND ADDRESS OF NEAREST RELATIVE IN THE U.S.A.
none.
IF APPLICANT GOES ON BUSINESS GIVE KA'-IE OF FIRM SPONSORING THE
TRIP
REQUIRED DOCUMENTS:
PASSPORT No. ISSUED BY DATE 7 Feb 63
POLICE CERTIFICATE ISSUED BY . D,,TE
HEALTH CERTIFICATE- ISSUED BY DATE_20_oV$2
VACCINATION CERTIFICATE ISSUED BY ]DATE29N= 62 -
TOURISTS MAY SHOW ANY OTHER DOCUIENT .S PROOF OF CITI MENSHIP:
I DECLARE. UNDER OATH THAT THE ABOVE INFORMATION IS TRUE AND CORRECT,
THAT MY ACTIVITIES WILL NOT TEND TO VIOL.TE ANY SALV.iDOREAN LAWS,
THAT I VILL NOT SEEK TO CHANGE MY VISA. STATUS, AND TIAT I AM IN
POSSESSION OF $250.oo OR ROUND TRIP TICKET.
District oLfwasia, $5:
On this 2nd day oS
- before me appeared . ,, . J. - C L 96L
persnally.knowm to e, who acknowledged PLACE AND DATE /
the above instrurent and armeitU.a m
in n7 presance. I
!;47 Noury PUN,: in allfo-
Womov~ VIems Tr n:)nan. m'ri APPLICANT'S SIGNATURtE -(if Minor
14-1514-10035
a
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