Questionnaire: DS-160 (Nonimmigrant visa)

Questionnaire: DS-160

Who will be completing this DS-160 Questionnaire? (to add more press the "+" icon)(Required)

Last Name (Surname)

First Name (Given Name)

Email Address

This will let us know who to contact if we have any questions regarding your answers.

BEGIN DS-160 QUESTIONNAIRE: PART A - PERSONAL INFORMATION(Required)

Begin DS-160 Questionnaire

I'll come back later

NOTE: Please make sure that you have the following Documents/Scanned items to upload BEFORE you begin the DS-160 Questionnaire. DOCUMENT CHECKLIST: 1) ANY U.S. ISSUED VISAS; 2) PASSPORT BIOPAGE; 3) CURRICULUM VITAE; 4) DIPLOMA(S). ALSO NOTE: The information you provide to us is important, and is safe, secure and encrypted.

PART A - PERSONAL INFORMATION

Last Name (Surname)(Required)

First Name (Given Name)(Required)

Middle Name (Second Name)

Other Names Used (Maiden, Professional, Religious, Aliases)

Do you have a telecode that represents your name?(Required)

Yes

Telecode Last Name (Surname)(Required)

Telecode First Name (Given Name)(Required)

Sex(Required)

Male

Female

Marital Status(Required)

Single

Married

Common Law Marriage

Civil Union / Domestic Partnership

Widowed

Divorced

Legally Separated

Other

Date of Birth (TAG/MONAT/JAHR)(Required)

City of Birth(Required)

State/Province of Birth (if applicable)

Country/Region of Birth(Required)

Country/Region of Origin (Nationality)(Required)

Do you hold any other nationalities?(Required)

Yes

Other Nationality (list ALL nationalities you are currently holding OR ever held - to add more press the "+" icon)(Required)

Are you a permanent resident of a country/region other than your nationality listed above?(Required)

Yes

List the Country/Region other than your nationality(Required)

National Identification Number (if applicable)

Personalausweisnr.

U.S. Social Security Number (if applicable)

U.S. Tax Payer Number (if applicable)

CONTINUE TO PART B - TRAVEL INFORMATION?(Required)

Yes - I have completed PART A and would like to continue to PART B

No - Remember to "Save and Continue Later"

IMPORTANT: You must click "Save and Continue Later" to save your entries.

PART B - TRAVEL INFORMATION

Purpose of Trip to the U.S. (select visa class)(Required)

Have you made specific travel plans?(Required)

Yes

Date of Arrival in U.S.(Required)

Arrival Flight Details(Required)

Airline and Flight Number

Does your specific travel plans include a departure date?(Required)

Yes

Date of Departure from U.S.(Required)

Departure Flight Details(Required)

Airline and Flight Number

Provide a list of the cities and states you plan to visit in the United States (to add more press the "+" icon)(Required)

City, State

Intended Date of Arrival(Required)

Intended Length of Stay in U.S.(Required)

Input a Number Only

Intended Length of Stay In U.S.(Required)

Address where you will stay in the U.S.(Required)

Street Address City State ZIP / Postal Code

Address where you intend to stay while in the U.S.(Required)

Street Address City State ZIP / Postal Code

Person/Entity Paying for Your Trip(Required)

Self

Other Person

Present Employer

Employer in the U.S.

Other Company/Organization

Are there other persons traveling with you?(Required)

Yes

List all persons traveling with you (to add more press the "+" icon)(Required)

Last Name (Surname)

First Name (Given Name)

Relationship to you

Have you ever been in the U.S.?(Required)

Yes

List all Dates and Length of Stay (to add more press the "+" icon)(Required)

Date (DD)

Month (MM)

Year (YYYY)

Length of Stay (#)

Length of Stay (Days/Weeks/Months/Years)

Have you ever been issued a U.S. visa?(Required)

Yes

Date last visa was issued(Required)

Visa Number(Required)

Are you applying for the same type of visa?(Required)

Yes

Are you applying in the same country or location where the visa above was issued?(Required)

Yes

Continuing from the previous question - Is this country or location your principal place of residence?(Required)

Yes

Have you been ten-printed?(Required)

Yes

Has your U.S. Visa ever been lost or stolen?(Required)

Yes

Has your U.S. Visa ever been cancelled or revoked?(Required)

Yes

Have you ever been refused a U.S. Visa, or been refused admission to the United States, or withdrawn your application at the port of entry?(Required)

Yes

Have you ever been denied travel authorization by the Department of Homeland Security through the Electronic System for Travel Authorization (ESTA)?(Required)

Yes

Has anyone ever filed an immigration petition on your behalf with the United States Citizenship and Immigration Services?(Required)

Yes

PRIOR VISA(S): Please upload a high quality, clear scan(s)/photo(s) of ANY & ALL PRIOR VISAS.(Required)

Drop files here or

Max. file size: 128 MB.

CONTINUE TO PART C - ADDRESS & PHONE INFORMATION?(Required)

Yes - I have completed PART B and would like to continue to PART C

No - Remember to "Save and Continue Later"

IMPORTANT: You must click "Save and Continue Later" to save your entries.

PART C - ADDRESS & PHONE INFORMATION

What is your current home address?(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is your mailing address the same as your home address?(Required)

Yes

What is your mailing address?(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Different than your home address

Primary Phone Number(Required)

Secondary Phone Number (if applicable)

Work Phone Number (if applicable)

Have you used any other phone numbers in the last five (5) years?(Required)

Yes

List all other phone numbers used in the last five (5) years (to add more press the "+" icon)(Required)

Email Address(Required)

Enter Email Confirm Email

Have you used any other email addresses in the last five (5) years?(Required)

Yes

List all other email addresses used in the last five (5) years (to add more press the "+" icon)(Required)

Do you or have you ever had a social media presence?(Required)

Yes

List ALL Social Media Accounts (to add more press the "+" icon)(Required)

Account Name (e.g. Facebook, Instagram, etc.)

Username/Handle (DO NOT ADD LINK)

Popular platforms including BUT not limited to the following: ASK.FM, CLUBHOUSE, DOUBAN, FACEBOOK, FLICKR, GOOGLE+, INSTAGRAM, LINKEDIN, MYSPACE, PINTEREST, QZONE (QQ), REDDIT, SINA WEIBO, TENCENT WEIBO, TUMBLR, TWITTER, TWOO, VINE, VKONTAKTE (VK), YOUKU, YOUTUBE, etc...

Do you wish to provide information about your presence on any other websites or applications you have used within the last five (5) years to create or share content (photos, videos, status updates, etc.?)(Required)

Yes

List the information you wish to provide regarding the previous question. (to add more press the "+" icon)(Required)

CONTINUE TO PART D - PASSPORT INFORMATION?(Required)

Yes - I have completed PART C and would like to continue to PART D

No - Remember to "Save and Continue Later"

IMPORTANT: You must click "Save and Continue Later" to save your entries.

PART D - PASSPORT INFORMATION

Do you have a Passport?(Required)

Yes

Passport Book Number

Passport Number/Travel Document Number(Required)

Country/Authority that Issued Passport/Travel Document(Required)

Where was the Passport/Travel Document Issued?(Required)

City State / Province (if shown on Passport) Country

Issuance Date(Required)

Expiration Date(Required)

Have you ever lost a passport?(Required)

Yes

Passport Number of the lost passport(Required)

Country that issued the lost passport(Required)

Have you ever had a passport stolen?(Required)

Yes

Passport Number of the stolen passport(Required)

Country that issued the stolen passport(Required)

PASSPORT: Please upload a high quality, clear scan/photo of your current PASSPORT BIOPAGE.(Required)

Max. file size: 128 MB.

CONTINUE TO PART E - U.S. POINT OF CONTACT INFORMATION?(Required)

Yes - I have completed PART D and would like to continue to PART E

No - Remember to "Save and Continue Later"

IMPORTANT: You must click "Save and Continue Later" to save your entries.

PART E - U.S. POINT OF CONTACT INFORMATION

Contact Person in the U.S.(Required)

Last Name (Surname) First Name (Given Name)

Relationship to you(Required)

Organization Name in the U.S. (if applicable)

U.S Contact Address(Required)

Street Address City State ZIP / Postal Code

U.S. Contact Phone Number(Required)

U.S. Contact Email Address(Required)

CONTINUE TO PART F - FAMILY INFORMATION?(Required)

Yes - I have completed PART E and would like to continue to PART F

No - Remember to "Save and Continue Later"

IMPORTANT: You must click "Save and Continue Later" to save your entries.

PART F - FAMILY INFORMATION

Do you know your Father's Details?(Required)

Yes

Father's Name

Last Name (Surname) First Name (Given Name)

Father's Date of Birth(Required)

Is your Father in the U.S.?(Required)

Yes

I don't know

Do you know your Mother's Details?(Required)

Yes

Mother's Name

Last Name (Surname) First Name (Given Name)

Mother's Date of Birth(Required)

Is your Mother in the U.S.?(Required)

Yes

I don't know

Do you have any IMMEDIATE RELATIVES, NOT including parents, in the U.S.?(Required)

Yes

I don't know

List ALL relatives below (to add more press the "+" icon)(Required)

Last Name (Surname)

First Name (Given Name)

Relationship to you

Relative's Immigration Status

Do you have or at any time have you had spouse?(Required)

Yes

How many times have you been married?(Required)

Are you still married or divorced?(Required)

1- Reason for Divorce?(Required)

1- Date of Divorce?(Required)

1- Spouse's Information(Required)

Last Name (Surname) First Name (Given Name)

1- Spouse's Date of Birth(Required)

1- Spouse's Citizenship(Required)

1- Spouse's Place of Birth (City)(Required)

1- Spouse's Place of Birth (Country)(Required)

1- Spouse's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

2- Former Spouse's Information(Required)

Last Name (Surname) First Name (Given Name)

2- Former Spouse's Date of Birth(Required)

2- Former Spouse's Citizenship(Required)

2- Former Spouse's Place of Birth (City)(Required)

2- Former Spouse's Place of Birth (Country)(Required)

2- Reason for Divorce?(Required)

2- Date of Marriage with Former Spouse?(Required)

2- Date of Divorce from Former Spouse?(Required)

3- Former Spouse's Information(Required)

Last Name (Surname) First Name (Given Name)

3- Former Spouse's Date of Birth(Required)

3- Former Spouse's Citizenship(Required)

3- Former Spouse's Place of Birth (City)(Required)

3- Former Spouse's Place of Birth (Country)(Required)

3- Reason for Divorce?(Required)

3- Date of Marriage with Former Spouse?(Required)

3- Date of Divorce from Former Spouse?(Required)

4- Former Spouse's Information(Required)

Last Name (Surname) First Name (Given Name)

4- Former Spouse's Date of Birth(Required)

4- Former Spouse's Citizenship(Required)

4- Former Spouse's Place of Birth (City)(Required)

4- Former Spouse's Place of Birth (Country)(Required)

4- Reason for Divorce?(Required)

4- Date of Marriage with Former Spouse?(Required)

4- Date of Divorce from Former Spouse?(Required)

5- Former Spouse's Information(Required)

Last Name (Surname) First Name (Given Name)

5- Former Spouse's Date of Birth(Required)

5- Former Spouse's Citizenship(Required)

5- Former Spouse's Place of Birth (City)(Required)

5- Former Spouse's Place of Birth (Country)(Required)

5- Reason for Divorce?(Required)

5- Date of Marriage with Former Spouse?(Required)

5- Date of Divorce from Former Spouse?(Required)

CONTINUE TO PART G.1 - PRESENT WORK / EDUCATION / TRAINING INFORMATION?(Required)

Yes - I have completed PART F and would like to continue to PART G.1 (PRESENT)

No - Remember to "Save and Continue Later"

IMPORTANT: You must click "Save and Continue Later" to save your entries.

PART G.1 - PRESENT WORK / EDUCATION / TRAINING INFORMATION

Are you currently employed?(Required)

Yes

Are you currently attending school?(Required)

Yes

Primary Occupation / Profession / Student(Required)

Present Employer Name(Required)

Present Employer Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Present Employer Start Date(Required)

Present Employer's Phone Number(Required)

Monthly Salary in Local Currency(Required)

Briefly describe your present job duties(Required)

Do you need to add an additional CURRENT Employment?(Required)

Yes

Additional Present Employer Name(Required)

Additional Present Employer Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Additional Present Employer Start Date(Required)

Additional Present Employer's Phone Number(Required)

Monthly Salary in Local Currency (Additional Present Employment)(Required)

Briefly describe your additional present job duties(Required)

Present School Name(Required)

Present School Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Present School Start Date(Required)

Present School's Main Phone Number(Required)

Briefly describe your course of study(Required)

CONTINUE TO PART G.2 - PREVIOUS (5) FIVE YEARS OF WORK / EDUCATION / TRAINING INFORMATION?(Required)

Yes - I have completed PART F and would like to continue to PART G.2 (PREVIOUS 5 YEARS)

No - Remember to "Save and Continue Later"

IMPORTANT: You must click "Save and Continue Later" to save your entries.

PART G.2 - PREVIOUS (5) YEARS OF WORK / EDUCATION / TRAINING INFORMATION

Previous Employment Information for the last five (5) you were employed

Do you have PREVIOUS Employment?(Required)

Yes

1 - Previous Employer's Name(Required)

1 - Your Previous Job Title(Required)

1 - Previous Employer's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

1 - Previous Supervisor's Name (if known)

Last Name (Surname) First Name (Given Name)

1 - Previous Employment Start Date(Required)

1 - Previous Employment End Date(Required)

1 - Briefly describe your previous duties(Required)

Add Second Previous Employment?(Required)

Yes

2 - Previous Employer's Name(Required)

2 - Your Previous Job Title(Required)

2 - Previous Employer's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

2 - Supervisor's Name (if known)

Last Name (Surname) First Name (Given Name)

2 - Previous Employment Start Date(Required)

2 - Previous Employment End Date(Required)

2 - Briefly describe your previous duties(Required)

Add a Third Previous Employment?(Required)

Yes

3 - Previous Employer's Name(Required)

3 - Your Previous Job Title(Required)

3 - Previous Employer's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

3 - Supervisor's Name (if known)

Last Name (Surname) First Name (Given Name)

3 - Previous Employment Start Date(Required)

3 - Previous Employment End Date(Required)

3 - Briefly describe your previous duties(Required)

Educational Institutions: Have you attended any education institutions at a secondary level or above?(Required)

Yes

1 - Name of Institution(Required)

1 - Institution Street Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

1 - Start Date of Attendance(Required)

1 - End Date of Attendance(Required)

1 - Course of Study(Required)

Add a Secondary Educational Institution(Required)

Yes

2 - Name of Institution(Required)

2 - Institution Street Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

2 - Start Date of Attendance(Required)

2 - End Date of Attendance(Required)

2 - Course of Study(Required)

Add a Third Educational Institution(Required)

Yes

3 - Name of Institution(Required)

3 - Institution Street Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

3 - Start Date of Attendance(Required)

3 - End Date of Attendance(Required)

3 - Course of Study(Required)

CURRICULUM VITAE: Please upload your CURRICULUM VITAE.(Required)

Max. file size: 128 MB.

DIPLOMA(S): Please upload high quality scan(s)/photo(s) of your DIPLOMA(S).(Required)

Drop files here or

Max. file size: 128 MB.

CONTINUE TO PART H - ADDITIONAL INFORMATION?(Required)

Yes - I have completed PART G.2 and would like to continue to PART H

No - Remember to "Save and Continue Later"

IMPORTANT: You must click "Save and Continue Later" to save your entries.

PART H - ADDITIONAL INFORMATION

Do you belong to a clan or tribe?(Required)

Yes

Provide a List of Languages You Speak (to add more press the "+" icon)(Required)

Provide a List of Countries You Visited Within the Last Five (5) Years (to add more press the "+" icon)(Required)

Have you belonged to, contributed to, or worked for any professional, social, or charitable organization?(Required)

Yes

Do you have any specialized skills or training, such as firearms, explosives, nuclear, biological, or chemical experience?(Required)

Yes

If you answered "Yes" to the previous question, please explain(Required)

Have you ever served in the military?(Required)

Yes

Name of Country/Region where you served(Required)

Branch of Service(Required)

Rank/Position(Required)

Military Specialty(Required)

Start Date of Service(Required)

End Date of Service(Required)

Have you ever served in, been a member of, or been involved with a paramilitary unit, vigilante unit, rebel group, guerilla group, or insurgent organization?(Required)

Yes

CONTINUE TO PART I - SECURITY AND BACKGROUND INFORMATION?(Required)

Yes - I have completed PART H and would like to continue to PART I

No - Remember to "Save and Continue Later"

IMPORTANT: You must click "Save and Continue Later" to save your entries.

PART I - SECURITY AND BACKGROUND INFORMATION