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HomeMy WebLinkAbout2011 Passport RecertficationsMessage Confirmation Report FEB-11-2011 12:24 PM FRI Name/Number Page Start Time Elapsed Time Mode Results 3058100766 13 FEB-11-2011 12:21PM FRI 02' 57" STD ECM [0.K] Fax Number Name From Mao" Nitwit Agency 305-810-0766 To 040464 Date 12/3/2010 Time' 5:47 OO AM Ah11VUAL FRECI=FTIFICATIC'RI 201 US. Department Of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program s,A C ..,Ftcwusn u( r+aa am CUi;,piiar:rc Check f)ne' NEW ( 1 RE ANNUAL RECERTIFICATION ( ) Date /-0/ - e270// Facility Name e1 6 %sL07% Facility Street Address. OO fAsciilenbr haclliry ID Number Gi/044 rCiiy /»jad"/_ _ State F Zip r33JyJa P4 Facility Mailing Address ut.1,R.rrnq City State 22 Zlp Personnel Qualifications for Public Sector Employees %+ere ATarICe AgE r,.s rr..:9t t ; 1. Employees of a designated acceptance facility: 2. U.S. citizens' or nationals;*" d. Age I ii or older, 4. Permanent employees (not temporary, ad hoc, contractual, nor volunteer): 5. Free of Federal or State felony conviction; and S. Free of any misdemeanor conviction for crimes 'elated to breatft of trust or moral turpitude, e.g., embezzlement, identity theft, misappropriation, document fraud, drug offense, or dishonesty in carrying out a responsibility involving public trust. ' i-acility Manager must ri rimy that Acceptance Agents u. 1 U.S. citizens or U.S. nationals by seeing one o the following. ,/ U.S. Bf th Cerri; icate J Noturalization/Citizenship Certificate ,/ u.S. Passport ,/ t_.,n,ulur Report of firth Abroad " (1 S. nationals are individuals who are.bcrn in American Samoa or .Swains island, A certified btrrh certificate from American Samoa v. ;wuins Island is acceptable evidence of L.S. nationality. Any questions regarding on 4dtapranre agnn-'s tr S : ,12enship should be directed to the Regional CSMJ TraininC and Information Requirements j8IEC1IVE: Well-informed and Lnnfident Acceptance Agents 1 Passport Services provides Initial, Web -based agent training (WRT;, as well as In -person agent training, which Is conducted by Passport Services' staff. All new acceptance agents are required to successfully cep - piece the WBT before they begin to accept passport appllratirns. (The WIT may also be used as refresher training for experienced arceptance agents.) In addition to the Ws', ci' 1.1eptance agents must be familiar with policies and procedures as stated ancil illustrated in the current version of the Passport A eent's Reference Guide (PARC.), newsletters, and notices before accepting applications and must stay nl rren; with Changes in requirements, forms, procedures, ar'C fees. Tl'e PARC Is ,available In :.D, from which'7 may he printed, and for Postal acceptance agents, It is on the LISPS IntrAnw fr, rt. wire . ITalso ata,, he p^hied. If in -person training is offered within a reasonable distance of the acceptance facility, at least one accep- tance agent per facility should attend annually and if diffcrcnt, the staff rncmbcr serving as the facility's passport program manager should ...is() ai'erd. Consult tie Regional CSM for special training needs. CA/PI'1/T YCS.t011507 R'fi.. +t. 1= 1 C _) t= 5 2 818 Message Confirmation Report FEB-01-2011 01:12 PM TUE Fax Number Name Name/Number 3058100766 Page 13 Start Time FEB-01-2011 01:10PM TUE Elapsed Tine 02' 26" Mode STD ECM Results [ O. KJ From Seam Passport Agency JO5-810-0766 To. C40464 OM. 121312010 Time- 547 0e AM ..iVNUAL RERTIFICATIC/N 201 US. Department Of State Bureau of Consular Affairs Passport services Passport Application Acceptance Program PART it: #3k Cz tlfii::tion of Vi-oE., a.r Carat; liar cc Check One: NE'N ( ) 4Y ANNUAL RE-CERTWICATIO.J ( ) Date /- 5f - ci70// /%% Faclllty Name_ _ er.. �� ' "Ja�Z Facility � ID Number_ '1' 4 Facility Street Address - "41A44veut.' '? ty/7%ie ooli State Zip -56i3a Facility Mailing Address (itdirrerent) City State ^ _ Zip Personnel Qualifications for Public Sector Empkwees Acceptance Agents tr.tsi be: 1. Employees of a designated acceptance facility; 2. U.S. citizens' or nationals;'' 3 Age 18 or older; 1. Petmanent employees (not temporary, ad hoc, contractual, nor volunteer); 5. Free of Federal or State tclony Convittlon; and G. Free of any misdemeanor conviction fnr crimes related to breach of trust or moral turpitude, e.g., embezzlement, identity theft, misappropriation, document fraud, drug offense, or dishonesty in carrying out a responsibility Involving public trust. • Facility Manager must verify that Acceptance Agents are U S. citizens or U.S. nationals by seeing one of the following: U.S. Birth Certificate Naluralrrpt+On/Citizenship Certificate ✓ U.S. Passport ✓ Consular Report of Birth Ahrnad '• U.S. nationals are individuals who are born In American Samoa or Swains island, A certified birth certificate from American Samoa or Swains Island is acceptable evidence of VS, nationality. Any questions regarding an acceptance agent's U.S. Citizenship should be directed to the Regional CSM. Training and information Requirements OgiECTIVE well•Intormed and Confident Acceptance Agents Passport Services provides Initial, Web -based agent training (WRT, as well as in -person agent training, which is conducted by Passport Services' staff. All new acceptance agents are required to successfully com- plete the WBT before they begin to accept passport appliratic•ns. (The wiiT may also be used as refresher training for experienced acceptance agents.) In addition to :he WET, all acceptance agents must he familiar with p5lldes and procedures as stated and illustrated in the current version of t`d Passport. Agent's Reference Guide (PARC., newsletters, and notices before accepting applications and must stay current with changes in requirements, forms, procedures, anti fees. The PARC Is available on CD, from which r may be printed, and for Postal acceptance agents, it is on the 11SPS IntrAne-. from which it also may be p-inred. IF in -person training is offered within a reasonable distance of the acceptance facility, at least one accep• tance agent per facility should attend annually and if different, the staff member serving as the facility's passport program manager should also attend Consult the Regional CSM for special training needs CNrrrn'O'C'S-i al s97 F»AGF 1 OF 5 2016 From. Miami Passport Agency 305-810-0766 To: 040464 Gate: 12/3/2010 Time: 5:47:06 AM Page 2 of 6 ANNUAL. IRS"I 'ICACTK 011 U.S. Department Of State Bureau of Consular Affairs Passport Services Passport Application Acceptance. Program FART y }ACk ✓.kr44aIkof P irc.Cc; N�.b rt. �. cr 3.'vi ..tl Leaf YL.� Check One: NEW { ) gL ANNUAL RE-CER WICATIQN f ) Date /—e-3/ — c9°// Facility Name e- O ,"'JaA!/ Facility ID Number_ ol/4y6 Facility Street Address 3r5o0An41 lek"1"P i. /7? ,"/* _ State ri' zip 4-33/341 Facility Mailing Address (if different) City State .' _ Zip _"._ Personnel Qualifications for Public Sector Employees Accet: i=aice A e i s Itm,Jst. be 1, Employees of a designated acceptance facility; 2. U.S. citizens* or nationals;* 3: Age 18 or older; 4. Permanent employees (not temporary, ad hoc, contractual, nor volunteer); 5. Free of Federal or State felony conviction; and 6. Free of any misdemeanor conviction for crimes related to breach of trust or moral turpitude, e.g., embezzlement, ideritity theft, misappropriation, document fraud, drug offense, or dishonesty in carrying OUT a responsibility involving public trust. Facility Manager must verify that Acceptance Agents are U.S. citizens or U.S. nationals by seeing one of the following: U.S. Birth Certificate Naturalization/Citizenship Certificate U.S. Passport 1 Consular Report of Birth Abroad '`° U,S. nationals are individuals who are born in American Samoa or Swains island. A certified birth certificate from American Samoa or Swains Island is acceptable evidence of U:S. nationality. Any questions regarding an acceptance agent's U.S. citizenship should be directed to the Regional OM.. Training and Information Requirements OBJECTIVE Well-informed and Confident Acceptance Agents Passport Services provides Initial, Web -based agent training (WBT, as well as in -person agent training, which is conducted by Passport Services' staff. All new acceptance agents are required to successfully com- plete the WBT before they begin to accept passport applications. (The WBT may also be used as refresher training for experienced acceptance agents.) In addition ro the WBT, all acceptance gents must be familiar with polides and procedures .as stated and illustrated in the current version of the Passport Agent's Reference- Guide (PARR), newsletters, and notices. before accepting applications and must stay curren, with changes in requirements, forms, procedures, and fees. The PARC is available on CD, from which p_.may be printed, and for Postal acceptance agents, it is on the USPS IntrAnes; from which it also may be !tiririi.ed. If in -person training is offered within a reasonable distance of the acceptance facility, at least one accep- tance agent per facility should attend annually and if different, the staff member serving asthe facility's passport program manager should also attend. Consult the Regional CSM for special training :needs, CA/1'FT/FO..'c5-I0/15f07 P E ,1 F 5 From iv; am, Fasspor, hgency 3J5-6 v-u-6c To. •< <6 , mate. 2. 3.'2010 Time. 5.47.06 AM Page 3of6 ANNUAL. F 5 6 m F! C E NI 2011 r< . �r -' • �.1 4J.5. Department Of State Bureau of Consular Affairs C u35 77 Services Pass oo7t:-pplica.''.lon Acceptance in'roarani ifileck One: FIE't ( ) or MLIAL Rt CER 11R CATION ;48-7-- Acceptance Auents` flames, Sionatures, $:r U.S. Cft z nship/Nationaifty IDi:7c .Pi' entatiDn FacilityName _ �i Of ,Cl.. D y0 5 `/ � Facility ID Number Directrions A. The facility Manager requesting new (first -tune; :ertification or re -certification needs to en sure that all employees named as Passport Application Acceptance Agents meet Agent Qualifications and Requirements as outlined in PART I; #3. B. Please print or type each employee's name in Column 1 and have the employee sign to the right in Column IL C. In Column III, list the proof of U.S. citizenship seen by the Facility Manager to document each employee's U.S. citizenship,/nationality. Column I Employee's Name (Type or Print) Column II Employee's Signature Column I11 U.S. Citizenship/Nationality Document* - U 5. Birth Certificate or • Naturalization/Citizenship Certificate or • U.S. Passport or - Consular Report of Birth Abroad /11/;€14+41 ,9 14 • ),.62=_ US. OPAssfa.71 ,los.► CI4s71;i/o "..S. Als-rfor lUwigA Aa.,ie 2..1. 4' eth 6,0 4..+ �I%��'rie�,�,�' '2 de,e7 ;4 e 7 4i ilevore.•, UJ ®ma's,vel- c7o ya To.le.f et, Ip ..Pj,.., & 7iL 74 ; c .e- At—,.-, . 2. L>r / ,,. - _ !/. f . . / 3.1. /7.c.e..'64./ /)'%,c :ee z 717.7'''14 U•f • PA1spe. / ,Ro seolot,"0 D%i v4,c.¢ LI t J . Rts.r/o- Locia✓1n O/.#<A '�0.....,__ U J'. f4rrfoe f *Consult the Regional Passport Agency Cus mer Service an er for any citizenship/nationality questions. Please use second sheer if neede4. NOTE: If you wish to add employees in the future, please see Part fl: f4B—Acceptance Agent Changes. Prior approval is required and Part l: #3 Agent Qualifications and Requirements remain the same. PASSPORT APPLICATION LaSt Federal fiscal year WORKLOAD .3ctobei" t tc e.pte€ Io,:r = , facility ' NUIMER OF APP FIO CA/PPT/FO/CS-1 O/1 s/07 PAC3E2C F5 ',Arm Passport Agency 335-B10-0766 To: Late. 12/3:2010 Time: 5.47.06 AAA Page 4 of 6 ANNUAL 1---IE-EFCTIFIC,.ATICDNI 2011 O.S. Department Of State Bureau of Consular Affairs Passport Services Passport Application Ac eptarice Prograrrn Respon; titie~s of Facility Manager J Ensure Acceptance Agents uphold all legal responsibilities. By signing an appliz tion, the Agent is verifying that the customer, who personally appeared, the passport photos & the ID presented (as docu- mented) were one-in-the-sarne; that the applicant took the oath and signed the apalication—a.lt es per- sonally witnessed by the Acceptance Agent. ,( Provide the full range of service options to all Passport customers in a courteous and professional manner. J Employ enough trained Acceptance Agents to meet customer demand and provide quality passport service. (Advise Passport Regional Customer Service Manager if you assess your area needs additional facility designations to maintair, service levels.) J Oversee that every aspect of the process, including the disposition of execution fees, be void of the appearance of any impropriety, either real or perceived. J Collect only those fees authorized by the U.S. Department of State. J Display passport fee schedule easily seen by Agent and customer. J Ensure that all types of current passport applications and forms are always available. ,/ Ensure that the current version of the Passport Agent's Reference Guide (PARC) is available to all Acceptance Agents and that its guidance is followed, J Ensure News: etters and Notices (electronic and/or hartcopy) are shared in a timely manner with all Acceptance Agents. (If Newsletters are not received on a regular basis as established by your Regional Passport Agency, contact the CSM to avoid an information lapse.) ,/ Designate a secure area for passport transmittals and applications awaiting daily shipment to the Iockbox, ensuring separation of Routine and Expedited applications. Transmittal copies must be Maintained for one year. Only release passport application information to the customer and to Passport Services, and do not re- tain copies of executed applications or other personal forms or personal documents of customers. ,/ Refer any requests from law enforcement officials for passport application information directly to the Re Tonal Customer Service Manager to ensure that the Privacy Act is not violated. As Facility Manager, I certify that the _6. 1 OF ! i!% et.nr— ad/eV 4 FACILFITS NAME FACILITY ID* is in compliance With the preceding Personnel Requirements for Public Sector Employees; Training and inforrnaCon Requirernents; Acceptance Agents' Names, Signatures, and ti.S Citizenship Documentation; and that I fulfill all Responsibilities of Facility Manager for the Passport- Application Acceptance Program. i further understand that our partnership Wit continue as long as both this office and Passport Services find it agreeable. Should either wish to terminate the partnership, as much advance notification as possible shall be provided in an effort to avoid service disruption for customers*. For non -postal facilities; Please check (,/i one box: c My office issues birth certificates. yl.,My office does not issue birth errificares. PRNr FACILITY MANAGER'S NAME & TI'LE IG NATURE 'For US''3 Facilities. approval above the individual Post Office also may be required Tor service termination. `3/_ Poi! GATE SURMISSLOft Pease fax. er i il:., or nail this cornplete.d Certification of Program Compiisance (Part 11: r3A, t?, and C) co your Regional Passport Agency Customer Service tanager. For new facility desicgna- 'ian_ tgi e5t5, a REqi4ESE for Designation (Part ii, 41 or #21 must accEnpany it. Thank. sio-u,' CA/PPT/FO/cS-10/1510 i 5 From Miami Passport Agency 335-810-0766 To: G40464 Date. 12/3; 2010 Time. 5.47.06 AM Page 5 of 6 ANNUAL EC T!F CAT] N 7011 t;.. Depa.rtrnerL Of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program Date /— 3 I / Please C Facility Name- ei 117O it Facility Street Address _ ,3,$'DD peck One: Non -Postal ur Postai ( %Gt-/!?i Facility ID Number aVOW. 41 ,an 4i-ezie.orr a 33/3j Facility Mailing Address (If different) Please only report changed information. Submit to Passport Agency Regional CSlvl, P>;URLiC CON -TACT l` FOR<MAnO+ Phone305-851-)-705iax3o"5'258-/b/D Email =� Passport Hours of Operation: Mon. ffr'l I/"i _ Tues. Flip /f 't Wed. 5'0" — ZQ�" Thurs. 9 " 03°7 Fri...741,I _... 7t Sat. ekj Sun. - dfQS Zoe Closed during lunch? fie If so, hours closed? Are appointments required? 40 If so, phone Handicap accessible? _y‘1 Photos on-site?/4-_ Photos nearby? _. 144- PRIVATE CQNTACT *FORMATION FOR PASSPORT AGENCY USE This information will not be given to the public. Ree:f6L J Facility Manager's Narne and Title Ph one 396'dSG-S970 Fax _305--1S1-/4/D Email: PTilo.neeA aisfr7i4 41. Passport Program Manager .Indifferent) A'� /'� - -"Q' ee Phone 5,5TL 3b4Fax aOS'KSF-/L/b Email: mid%Q cf:rw7;a•niJ'V •E Other Contact Info for Passport Agency Use POSTAL FACILi T IES ONLY This information will not be given to the public_ District Retail Office Address: District Retail Manager's Name (DRM): Phone Fax r Email: CAiPPT'F0/CS• 10/15/07 IE 4Dom'5 ^rcr 'agar Passpor, Agency 305-E10-0766 To. C40464 Cate: 12/3,'2010 Time: 5:47.06 AIV1 Page 5 ol 6 ANNUAL_ E rIMTI 2011 U.S. Department Of State Bureau of Consular Affairs Passport Services Passport , pplicauu n Accep :nce Program :— cc ._e �a '— '' q� rG - ,� !C., ceca iar :e `Er:1:E k.€k'_,r, G+ needs to ensure that all em- as outlined in PART I, #3, pg. S. have the employee sign to the Manager to document Directions A. The Facility Manager requestng additional Acceptance Agents ployees named meet Agent Qualifications and Requirements B. Please print or type each employee's name in Column I and right in Column I1. C. In Column Ill, list the proof of U.S. citizenship seen by the Facility each employee's U.S. citizenship/nationality. Column 1 Employee's Name (Type or Print) Column 11 E nployee's Sigr attire Coit mn 111 US, atizenship/Nationality Document* • U.S. Birth Zertificaae or • idaturalizatiantutizensliip Certificate or - U.S. Psspart or - Consular Report of Birth Abroad ._ —A �.� .•U • S • Pass o.e� n'Lcnsult the Regional Passport Agency Customer Service Manager for citizenship/rationality Remove Former A c o ante Aoerr questions. 3. 1. --- 2. As Facility Manager, 1 certify 33-00 ®n .9ine.eiC is in compliance with all Personnel formation Requirements; Acceptance Nationality Docuni ntarion; port pplication Acceptance . d:410-, M.deetiet. PRINT FACILITY MANIACEk'S NAME that -_ di 4t'" �' 2%4.Ao NAME De ./ ✓.et lrl,'anH.c: R. FACILrrY .ADDRESS Requiremnents for Public Sector Agents' Names, Signatures, and that 1 fulfill all sponsiibilities of Program. . o y6 4/4FACILITY } FACILITY ID NLMBER I 33 /3 3 Employees: Training and In- and i,l.S. Citizenship/ Facility Manager for the Pass- 1_13 Ii/1 / s/2 _.a.._, & TITLE 5 NATURE DATE CA/PPf/FO/CS-1 0/ 15 f 0 7 Picik,E 5 DF Reports ---transcript Report transcript Organization: Generated Report: Status: All Last Name: First Name: Run Report, At 0 Details Download Member Primary 112 Organization martinezm Miami Passport 12/14/2010 Agency martinezm Miami Passport 12/14/2010 Agency martinezm Miami Passport 12/14/2010 Agency Grand Total: — (3 records ) Member Member Since Status Type Active Course Active Course Active Curriculum Title Assessment Refresher Course Review Passport Agent Refresher Course 2.5 Type Online Online Certificate Date Grade Score Completed 01/05/2011 92 01/05/2011 12/30/2010 http://paap.outstart.com/ppttraining/reporting/runCustomizedReport.gpi?pagecontents=runreport.jsp[1/5/2011 12:51:31 PM] Arcia, Miriam From: Sent: To: Subject: Attachments: Generated Report: Danie, Dwight Wednesday, December 15, 2010 4:36 PM Arcia, Miriam Passport Refresher - Transcript Dwig h t_Pa ssport_T ra n scri pt_Dec 15_2010. pdf Member Primary ID Organization danieds Miami Passport Agency danieds Miami Passport Agency danieds Miami Passport Agency Member Member Obiect Since Status Type 12/14/2010 Active Course 12/14/2010 Active Course 12/14/2010 Active Grand Total: — (3 records ) Thanks, Dwight S. Danie, MSL Elections Coordinator City of Miami Office of the City Clerk Telephone: 305-250-5358 Facsimile: 305-250-5487 ddanie@miamigov.com Title Assessment Refresher Course Review Curriculum Passport Agent Refresher Course 2.5 Type Date Grade Score Completed Online 12/15/2010 100 Online 12/15/2010 Certificate 12/15/2010 Note: The City of Miami is a public entity subject to Chapter 119 of the Florida Statutes concerning public records. E-mail messages are covered under such lauds, and thus subject to disclosure. All e-moils sent and received are captured by the City's servers and kept as a public record. 1 Arcia, Miriam From: Ewan, Nicole Sent: Wednesday, December 15, 2010 4:44 PM To: Arcia, Miriam Subject: Emailing: Reports -- Student Transcript - Passport Training Report Student Transcript Organization: Status: [All V] Last Name: First Name: Run Report Generated Report: Details Download Member Primary Member Member Object Title ID Organization Since Status Type ewannn Miami Passport 12/14/2010 Active Course Assessment Agency ewannn Miami Passport 12/14/2010 Active Course Refresher Course Review Agency ewannn Miami Passport 12/14/2010 Active Agency Grand Total: — (3 records)"'` Type Online Date Grade Score Completed 12/14/2010 96.67 Online 12/14/2010 Curriculum Passport Agent Refresher Course Certificate 12/14/2010 2.5 1 Reports -- transcript Details Download transcript Organization: Generated Report: Member Primary Organization hannontb Miami Passport Agency hannontb Miami Passport Agency hannontb Miami Passport Agency Status: Last Name: Hannon Member Member Object Since Status Type 12/14/2010 Active Course Assessment Online First Name: Todd Title Type Run Report Date Grade Score Completed 12/29/2010 10: 12/14/2010 Active Course Refresher Online 12/29/2010 Course Review 12/14/2010 Active Curriculum Passport Certificate 12/29/2010 Agent Refresher Course 2.5 http://paap.outstart.com/ppttraining/reporting/runCustomizedReport.gpi?pagecontents=runreport.jsp[1/5/2011 11:10:37 AM] AstessTent - avdows :nte.net EYDIere, Assessment ..:".;:,.: • Ell ,1 Il• i 63,e. .s ,•17•pl, ,-,...s fr• a ,, -.:, passp, t t., e , • 0:- e h.s., ,=:,-- D-E -11 :sapes 1 ,nd , 1 c, • ,.-., ,-s•Wei Fi, ca :01S, •se,t1f.ate ' S•sle -. , .sg 0 .s, gs.,:: . 1 1 0 1 0 1.0 1 0 .1...0 S.,. 10 ),:s• ' f,13:1: t: tal st,srl.s.s. -11, ......,ss.. '-.-. as5e.,:.:ie tl, 6.34e,s F0:10 E., 11" 1 0 1 C. : 0 1 0 1:t:: •:",. 1.I 1" M. J::•.,,,,, s 1:t.s.i-us. .ss_el ..., S pass,,, -..s aispi.c3.t.0n' S.,,e,:t a:I tha, aPP:, 1,3 H0, 013:1: staples .,,,11,,, LISE ::, assembs '-,0 :,,,,,, S 30,34r:3:33r pac kage- 1 0 1 `.: 1 0 1 ) 1•::, .2- • - r 1, E :-.1.,e 3:3,3C3tIOnS 33uSt be sh,pped —. I tas s 30! ,..011: 3..p:...: t ,..,., ..1.1 1 0 1 0 1 0 1 0 1,::::.., 3s, r— i.o i .:, 1 "i Total t II 0.98 1.0 98.33% Total ''itirr4INNMENSPV1,9;ilitAtft. ' 0.98 1.0 48,333/4 Close 66r 6,;.6 Reports -- transcript Page 1 of 1 transcript Organization: Status: All • Last Name: Details Download First Name: Run Report Generated Report: Member Primary Member Member Obiect Title Tvpe Date Grade Score ID Organization Since Status Type Completed oliverar Miami 12/14/2010 Active Course Assessment Online 12/29/2010 96.67 Passport I Agency oliverar Miami 12/14/2010 Active Course Refresher Online 12/29/2010 Passport Course Agency Review oliverar Miami 12/14/2010 Active Curriculum Passport Certificate 12/29/2010 Passport Agent Agency Refresher Course 2.5 Grand Total: — (3 records ) http://paap.outstart.com/ppttraining/reporting/runCustomizedReport.gpi?pagecontents=ru... 12/29/2010 Learning Portal Page 1 of 1 V 0 Passport Agent Refresher Course 2.5 J 0 Refresher Course Review 9 .._Incomplete .............._...._..................I Score:N/A 1._Enrolled: ......._14 Dec 2010 Assessment Passed Score: 100.0 Enrolled: 14 Dec 2010 http://paap.outstart.com/ppttraining/lms 1/18/2011 Learning Portal Page 1 of 1 My Completed Activities options - Passport Agent Refresher Course 2.5 `4.) Refresher Course Review 4.9 Complete 0 , Assessment ) Passed Score: 0.0 128 Jan 2011 Score: 100.0 28 Jan 2011 Try 1 I��N�Fs� http: //paap. outstart. c om/ppttrai ni ng/lms 1/28/2011 U.S. Department of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program On -Line Training Request Form Please hay a each A2ent from your Facility complete this form in its entirety for enrollment in the Web - Based Training. Today's Date: / 2 /9 7?,,S"l0 WBT Refresher WBT ✓ Acceptance Facility Name: City Of Miami Acceptance Facility Number: 040464 Acceptance Facility Manager: Miriam M. Arcia Acceptance Facility Address: 3500 Pan American Drive Acceptance Facility City/State/Zip Code: Miami, FL 33133 Acceptance Facility Phone Number: 305-859-2705 Acceptance Facility Fax Number: 305-858-1610 Agent's First Name: i s k r Agent's Middle Name: Ste P h ei Agent's Last Name: 1J P\ NZ E Agent's Date of Birth: 0 7/2 3/0 53 E-Mail Address (Work E-Mail Only): 11>i m t C - M M 1 6-U V- C 0 YVi A valid, employer issued E-Mail address is required for each Acceptance Agent. Acceptance Agents who do not possess an E-Mail Address, should consult with their Facility Manager for use of the Facility Manager's E-Mail Address. The provided E-Mail Address will only be used to provide each enrollee with a User Name and Password. Please return completed forms to the Miami Passport Agency Customer Service Section by email to MiamiAF(a,State.Gov or by fax to fax number (305) 810-0766. If you have any questions, please contact Customer Service Assistants Svetlana Cebic at (305) 810-0761 or Rose Mederick at (305) 810-0765. U.S. Department of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program On -Line Training Request Form Please have each Agent from your Facility complete this form in its entirety for enrollment in the Web - Based Training. Today's Date: / Z/q Iio WBT Refresher WBT v� Acceptance Facility Name: City Of Miami Acceptance Facility Number: 040464 Acceptance Facility Manager: Miriam M. Arcia Acceptance Facility Address: 3500 Pan American Drive Acceptance Facility City/State/Zip Code: Miami, FL 33133 Acceptance Facility Phone Number: 305-859-2705 Acceptance Facility Fax Number: 305-858-1610 Agent's First Name: /\Ji 640 lr Agent's Middle Name: /ALL( -/ l SI) a Agent's Last Name: kJ eV tZ ) Agent's Date of Birth: o 7 ' I U' 90 E-Mail Address (Work E-Mail Only): fewarl @ /'y)i ni ✓l a✓- CLw Y) A valid, employer issued E-Mail address is required for each Acceptance Agent. Acceptance Agents who do not possess an E-Mail Address, should consult with their Facility Manager for use of the Facility Manager's E-Mail Address. The provided E-Mail Address will only be used to provide each enrollee with a User Name and Password. Please return completed forms to the Miami Passport Agency Customer Service Section by email to MiamiAF@State.Gov or by fax to fax number (305) 810-0766. If you have any questions, please contact Customer Service Assistants Svetlana Cebic at (305) 810-0761 or Rose Mederick at (305) 810-0765. U.S. Department of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program On -Line Training Request Form Please have each A2ent from your Facility complete this form in its entiretv for enrollment in the Web - Based Training. Today's Date: la-� - 10 WBT Refresher WBT )'\ Acceptance Facility Name: City Of Miami Acceptance Facility Number: 040464 Acceptance Facility Manager: Miriam M. Arcia Acceptance Facility Address: 3500 Pan American Drive Acceptance Facility City/State/Zip Code: Miami, FL 33133 Acceptance Facility Phone Number: 305-859-2705 Acceptance Facility Fax Number: 305-858-1610 Agent's First Name: 'TO GA Agent's Middle Name: U c-1f 1 C'\ an Agent's Last Name: kAO.YW10 (\ Agent's Date of Birth: Q ' a3 — 1 611 4 E-Mail Address (Work E-Mail Only): ` q �(1 Y1 bY1 M 1 a YY1 \ ' 1 sDV Corr\ A valid, employer issued E-Mail address is required for each Acceptance Agent. Acceptance Agents who do not possess an E-Mail Address, should consult with their Facility Manager for use of the Facility Manager's E-Mail Address. The provided E-Mail Address will only be used to provide each enrollee with a User Name and Password. Please return completed forms to the Miami Passport Agency Customer Service Section by email to MiamiAF@State.Gov or by fax to fax number (305) 810-0766. If you have any questions, please contact Customer Service Assistants Svetlana Cebic at (305) 810-0761 or Rose Mederick at (305) 810-0765. U.S. Department of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program On -Line Training Request Form Please have each A2ent from your Facility complete this form in its entirety for enrollment in the Web - Based Training. Today's Date: e�i�i c, q 9,010 WBT Refresher WBT Acceptance Facility Name: City Of Miami Acceptance Facility Number: 040464 Acceptance Facility Manager: Miriam M. Arcia Acceptance Facility Address: 3500 Pan American Drive Acceptance Facility City/State/Zip Code: Miami, FL 33133 Acceptance Facility Phone Number: 305-859-2705 Acceptance Facility Fax Number: 305-858-1610 Agent's First Name: J by Agent's Middle Name: AI Agent's Last Name: D \ovv,.5 Agent's Date of Birth: , ) 1 ` In 3 E-Mail Address (Work E-Mail Only): \ \ Q 1(\- 5 C.9 YY1 Q al 1,5 nV y C,O YY' A valid, employer issued E-Mail address is required for each Acceptance Agent. Acceptance Agents who do not possess an E-Mail Address, should consult with their Facility Manager for use of the Facility Manager's E-Mail Address. The provided E-Mail Address will only be used to provide each enrollee with a User Name and Password. Please return completed forms to the Miami Passport Agency Customer Service Section by email to MiamiAF@State.Gov or by fax to fax number (305) 810-0766. If you have any questions, please contact Customer Service Assistants Svetlana Cebic at (305) 810-0761 or Rose Mederick at (305) 810-0765. U.S. Depailulent of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program On -Line Training Request Form Please have each Agent from your Facility complete this form in its entirety for enrollment in the Web - Based Training. Today's Date: 1)e,e,eiy, ber 61, 2oi 0 WBT Refresher WBT v Acceptance Facility Name: City Of Miami Acceptance Facility Number: 040464 Acceptance Facility Manager: Miriam M. Arcia Acceptance Facility Address: 3500 Pan American Drive Acceptance Facility City/State/Zip Code: Miami, FL 33133 Acceptance Facility Phone Number: 305-859-2705 Acceptance Facility Fax Number: 305-858-1610 Agent's First Name: Q M ell a. Agent's Middle Name: Y i anc4 e4 Agent's Last Name: L t.Lok e- L r 0 Yc- Agent's Date of Birth: May lea, 1G1o4 E-Mail Address (Work E-Mail Only): piU £- (- -- 1041n ore £ main � Q OY. C:dm A valid, employer issued E-Mail address is required for each Acceptance Agent. Acceptance Agents who do not possess an E-Mail Address, should consult with their Facility Manager for use of the Facility Manager's E-Mail Address. The provided E-Mail Address will only be used to provide each enrollee with a User Name and Password. Please return completed forms to the Miami Passport Agency Customer Service Section by email to MiamiAF@State.Gov or by fax to fax number (305) 810-0766. If you have any questions, please contact Customer Service Assistants Svetlana Cebic at (305) 810-0761 or Rose Mederick at (305) 810-0765. U.S. Department of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program On -Line Training Request Form Please have each Agent from your Facility complete this form in its entirety for enrollment in the Web - Based Training. Today's Date: Jecem be r WBT Refresher WBT Acceptance Facility Name: City Of Miami Acceptance Facility Number: 040464 Acceptance Facility Manager: Miriam M. Arcia Acceptance Facility Address: 3500 Pan American Drive Acceptance Facility City/State/Zip Code: Miami, FL 33133 Acceptance Facility Phone Number: 305-859-2705 Acceptance Facility Fax Number: 305-858-1610 Agent's First Name: in Gc.r. 1 b E Agent's Middle Name: rna-rt nez Agent's Last Name: Agent's Date of Birth: 9 /'2 O /7 E-Mail Address (Work E-Mail Only): (G rl be' mO9 c • ml&v i I - T • �S A valid, employer issued E-Mail address is required for each Acceptance Agent. Acceptance Agents who do not possess an E-Mail Address, should consult with their Facility Manager for use of the Facility Manager's E-Mail Address. The provided E-Mail Address will only be used to provide each enrollee with a User Name and Password. Please return completed forms to the Miami Passport Agency Customer Service Section by email to MiamiAF@State.Gov or by fax to fax number (305) 810-0766. If you have any questions, please contact Customer Service Assistants Svetlana Cebic at (305) 810-0761 or Rose Mederick at (305) 810-0765. U.S. Department of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program On -Line Training Request Form Please have each Agent from your Facility complete this form in its entirety for enrollment in the Web - Based Training. Today's Date: De, ccn4 bof 9, aot o WBT Refresher WBT Acceptance Facility Name: City Of Miami Acceptance Facility Number: 040464 Acceptance Facility Manager: Miriam M. Arcia Acceptance Facility Address: 3500 Pan American Drive Acceptance Facility City/State/Zip Code: Miami, FL 33133 Acceptance Facility Phone Number: 305-859-2705 Acceptance Facility Fax Number: 305-858-1610 Agent's First Name: Ro-se vil all Agent's Middle Name: / Agent's Last Name: 0 I i J O— a. Agent's Date of Birth: Oil- 11- rib E-Mail Address (Work E-Mail Only): rol 1 dcr& (V] j a pli 9 0 U. e.On1 A valid, employer issued E-Mail address is required for each Acceptance Agent. Acceptance Agents who do not possess an E-Mail Address, should consult with their Facility Manager for use of the Facility Manager's E-Mail Address. The provided E-Mail Address will only be used to provide each enrollee with a User Name and Password. Please return completed forms to the Miami Passport Agency Customer Service Section by email to MiamiAF@State.Gov or by fax to fax number (305) 810-0766. If you have any questions, please contact Customer Service Assistants Svetlana Cebic at (305) 810-0761 or Rose Mederick at (305) 810-0765. U.S. Department of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program On -Line Training Request Form Please have each Agent from your Facility complete this form in its entirety for enrollment in the Web - Based Training. Today's Date: 1 2-I D- 1 0 WBT Refresher WBT /\ Acceptance Facility Name: City Of Miami Acceptance Facility Number: 040464 Acceptance Facility Manager: Miriam M. Arcia Acceptance Facility Address: 3500 Pan American Drive Acceptance Facility City/State/Zip Code: Miami, FL 33133 Acceptance Facility Phone Number: 305-859-2705 Acceptance Facility Fax Number: 305-858-1610 Agent's First Name: L ( { I Ck tom? Kl Agent's Middle Name: Agent's Last Name: g 0 1/9- Agent's Date of Birth: -a E-Mail Address (Work E-Mail Only): A valid, employer issued E-Mail address is required for each Acceptance Agent. Acceptance Agents who do not possess an E-Mail Address, should consult with their Facility Manager for use of the Facility Manager's E-Mail Address. The provided E-Mail Address will only be used to provide each enrollee with a User Name and Password. Please return completed forms to the Miami Passport Agency Customer Service Section by email to MiamiAF@State.Gov or by fax to fax number (305) 810-0766. If you have any questions, please contact Customer Service Assistants Svetlana Cebic at (305) 810-0761 or Rose Mederick at (305) 810-0765. U.S. Department of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program On -Line Training Request Form Please have each Agent from your Facility complete this form in its entirety for enrollment in the Vs eb- Based Training. Today's Date: V` 9 - a0 `2 WBT Refresher WBT Acceptance Facility Name: City Of Miami Acceptance Facility Number: 040464 Acceptance Facility Manager: Miriam M. Arcia Acceptance Facility Address: 3500 Pan American Drive Acceptance Facility City/State/Zip Code: Miami, FL 33133 Acceptance Facility Phone Number: 305-859-2705 Acceptance Facility Fax Number: 305-858-1610 Agent's First Name: Agent's Middle Name: � 11. Agent's Last Name: / i� O M C 5 Agent's Date of Birth: Di 02- 1 9 51 E-Mail Address (Work E-Mail Only): 4-1f 1'ko rya 5 @ 6 y- 1 90V • Co A valid, employer issued E-Mail address is required for each Acceptance Agent. Acceptance Agents who do not possess an E-Mail Address, should consult with their Facility Manager for use of the Facility Manager's E-Mail Address. The provided E-Mail Address will only be used to provide each enrollee with a User Name and Password. Please return completed forms to the Miami Passport Agency Customer Service Section by email to MiamiAF@State.Gov or by fax to fax number (305) 810-0766. If you have any questions, please contact Customer Service Assistants Svetlana Cebic at (305) 810-0761 or Rose Mederick at (305) 810-0765. U.S. Department of State Bureau of Consular Affairs Passport Services Passport Application Acceptance Program On -Line Training Request Form Please has a each Agent from your Facility complete this form in its entirety for enrollment in the Web - Based Training Today's Date: / ! ' / 0 WBT . _ _ Refresher WBT Acceptance Facility Name: City Of Miami Acceptance Facility Number: 040464 Acceptance Facility Manager: Miriam M. Arcia Acceptance Facility Address: 3500 Pan American Drive Acceptance Facility City/State/Zip Code: Miami, FL 33133 Acceptance Facility Phone Number: 305-859-2705 Acceptance Facility Fax Number: 305-858-1610 Agent's First Name: Agent's Middle Name: AN 6 6 / EN f Agent's Last Name: _ � J 4 PAC) pJ Agent's Date of Birth: 0 - 0-11- /9s_ / E-Mail Address (Work E-Mail Only): F'p rs o P ©'yv .1 C d t/, yv` A valid, employer issued E-Mail address is required for each Acceptance Agent. Acceptance Agents who do not possess an E-Mail Address, should consult with their Facility Manager for use of the Facility Manager's E-Mail Address. The provided E-Mail Address will only be used to provide each enrollee with a User Name and Password. Please return completed forms to the Miami Passport Agency Customer Service Section by email to MiamiAF@State.Gov or by fax to fax number (305) 810-0766. If you have any questions, please contact Customer Service Assistants Svetlana Cebic at (305) 810-0761 or Rose Mederick at (305) 810-0765.