[| Document Summary: This is a blank Foreign Fighter Coordination Form issued by the Islamic State, Immigration Committee, and includes personal information reyarding the Recommending Party and the Foreign Fighter. The form includes instructions on the proper preedures to enter accurate informationubout the coordinator and the applicant. ~ [Beginning of Transation} [Page | of 2) ‘The Islamic State Immigration Commitee Date Governeate Taonication | Regus | ce eae 4 Forcign Fighter Coordination Request Form z try of Origin” Country of Departure ‘ontaet Inform: Communicanon Method Communication Details © Calling © WhatsAppe? Telegran® Skype | Real Name: | Seay Simon] Spay What is your relation to the recommended Relative © Friend © Other: ..“Travel Documents D Ready Cy Not read Ts this individual banned from travel? [© Yes C7 NO. Communication formation ‘Communication Method ‘Communication Method © Calling © Whatsapp © Telegram Skype ‘Ent aod Accompany information ‘Estimated Entry Date ‘Accompanied by [Page 2 of 2) '* Coordination’s rules and regulation : 1, Fill out the form completely with complete honesty. 2, Enter the same alias and name which is written in this form 3. The applicant information bas to be verified and stamped by his direct Emir, General ‘Administrator, or Foreign Fighters Affairs. The person who stamps this form will be responsible in front of the Sharia Court in this life and in front of God in the hereafter. Stamp of your direct Emir {End of Translation]