1. FULL NAME

SEN, MEHMET

2. DATE AND PLACE OF BIRTH

Date of Birth:	06	September	1970

	Day	Month	Year
Place of Birth:	Balikesir,		Turkey

	City/Town,	District/ County/ Province,	Country

3. THE APPLICANT'S NATIVE COUNTRY IF DIFFERENT FROM COUNTRY OF BIRTH

4. NAME, DATE AND PLACE OF BIRTH OF THE APPLICANT'S SPOUSE AND CHILDREN (IF ANY):

Spouse:	SEN, SELMA	18 July 1979	Balikesir, Turkey

	Name	Date of birth(day,month,year)	Place of birth

Child:	SEN, ZEYNEP NUR	20 May 1997	Syracuse, Onondaga, USA

	Name	Date of birth(day,month,year)	Place of birth

5. FULL MAILING ADDRESS:

116 Blossom Road Apt 3

Syracuse, NY 13224

6. PHOTOGRAPH:

7. SIGNATURE: