To:

From:

Signature:

Re:	We received a petition from the J-1 Exchange Visitor listed below to be transfer in to our program at the University of Puerto Rico, Río Piedras Campus. Please review the information that we intend to enter on the DS-2019, if transferred out of your program. If you agree with this transfer, please process the “transfer out” in SEVIS. If the transfer cannot be approved as requested, please contact us at info.dari@upr.edu or (787) 764-0000, ext. 86200, 86205.

NEW PROGRAM SPONSOR INFORMATION

Name of Exchange Program:

Program Number:

Name of Visitor:

Date of Birth:

Exchange Visitor Category:

Proposed Dates at UPR	From: To:

Subject/Field Code Description:

EXCHANGE VISITOR TRANSFER OUT REQUEST

I request that my program sponsorship be transfer to the University of Puerto Rico, Río Piedras Campus, Program Number , effective on .

Exchange Visitor Name	Exchange Visitor Signature	Date

CONFIRMATION OF TRANSFER BY OLD SPONSOR

I confirm that we will transfer the SEVIS record for to the University of Puerto Rico, Río Piedras Campus, for this Exchange Visitor, effective on .

Name of Responsible (RO) or	Signature of Responsible (RO) or	Date

Alternate Responsible Officer	Alternate Responsible Officer

Rev. Dec., 2016