DS 160 - Manisha Holidays

DS 160 U.S. Visa Application

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Personal Details - Step 1 of 7

Name

First

Last

Gender

Male
Female
Other

Marital Status

Married
Un Married

Date of Birth

Country / Region of Birth

Nationality

Other Nationalities

National Identification Number

U.S. Social Security Number

U.S. Taxpayer ID Number

Home Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Same Mailing Address

Mailing Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Primary Phone Number

Secondary Phone Number

Work Phone Number

Email Addresss

Passport/ Travel Document Type:

Passport/ Travel Document Number

Passport Book Number

Country / Authority that Issued Passport / Travel Document

City where issued

State / Province where issued

Country / Region where issued

Issuance Date

Expiraton Date

Have you ever lost a possport or had one stolen?

Upload Passport

Both side page detail

Purpose of Trip to the U.S.

Have You made specific travel plans?

Intended Date of Arrival:

Intended Lenght of stay in U.S.:

Person / Entity Paying for Your Trip:

Address where you will stay in the U.S.

Will you be staying with someone you know?

If yes
If No

What is the first name of the person you will be staying with?

What is the surname of the person you will be staying with?

What your relationship with the person you will be staying with?

Enter the address of the person you will be staying with

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email Address

Contact Number

Enter the name of the hotel you will be staying at

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Contact Number

Email Address

Are there other people traveling with you?

If yes provide below details
If no- Skip

What your relationship?

What is the first name of the person you will be traveling with?

What is the surname

Passport Number

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Contact Number

Are you Traveling as part of a group or Organization?

Have you ever been in the U.S.?

Visa Number:

Issued From:

Contact Person Name in the U.S.:

Organization Name in the U.S:

Relationship to you:

U.S. Contact Address:

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Email Address

Have you finalised your travel plans?

Which city will you enter USA from?

What date do you plan to reach USA?

What date do you plan to leave USA?

Which city will you depart USA from?

Enter all cities you plan to visit in USA

List all countries you've visited in the last 5 years

Father Name

Father's date of Birth

Is your Father in the U.S.?

Mother Name

Mother's date of Birth

Is your Mother in the U.S.?

Do you have any immediate relatives, not including parents in the U.S.?

Name

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Do you have any other relatives in the United States?

Name

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Share the link or handle of your social media profiles

I don't have any social media

Share the link or handle of your social media profiles

What is your occupation type?

If student
Employed
Business owner

What is the name of your educational institution?

What is the address of your educational institution?

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

What is the phone number of your educational institution?

When did you join your educational institution?

What is the Name of your company?

What is the Address of your company?

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

What is the phone number of your Company?

When did you start your company?

What is your monthly income?

Briefly describe what your role entails

Have you been employed previously?

What is the Name of your company?

What is the Address of your company?

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

What is the phone number of your Company?

When did you start your company?

What is your monthly income?

Briefly describe what your role entails

What is the highest level of education completed by you?

What is the name of your masters college?

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

What was your first day of attendance at your masters college?

What was the last day of attendance at your masters college?

List all languages you know.

Do you have a communicable disease of public health significance? (Communicable diseases of public significanceinclude chancroid, gonorrhea, granuloma inguinale, infectious leprosy, lymphogranuloma venereum, infectiousstage syphilis, active tuberculosis, and others diseases as determined by the Department of Health and HumanServices.)

Do you have a mental or physical disorder that poses or is likely to pose a threat to the safety or welfare ofyourself or others?

Are you or have you ever been a drug abuser or addict?

Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty, orother similar action?

Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substances?

Are you coming to the United States to engage in prostitution or unlawful commercialized vice or have you beenengaged in prostitution or procuring prostitutes within the past 10 years?

Have you ever been involved in, or do you seek to engage in, money laundering?

Have you ever committed or conspired to commit a human trafficking offense in the United States or outside theUnited States?

Are you the spouse, son, or daughter of an individual who has committed or conspired to commit a humantrafficking offense in the United States or outside the United States and have you within the last five years,knowingly benefited from the trafficking activities?

Have you knowingly aided, abetted, assisted or colluded with an individual who has committed or conspired tocommit a severe human trafficking offense in the United States or outside the United States?

Do you seek to engage in espionage, sabotage, export control violations, or any other illegal activity while in theUnited States?

Do you seek to engage in terrorist activities while in the United States or have you ever engaged in terroristactivities?

Have you ever or do you intend to provide financial assistance or other support to terrorists or terroristorganizations?

Are you a member or representative of a terrorist organization?

Are you the spouse, son, or daughter of an individual who has engaged in terrorist activity, including providingfinancial assistance or other support to terrorists or terrorist organizations, in the last five years?

Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide?

Have you ever committed, ordered, incited, assisted, or otherwise participated in torture?

Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings, political killings,or other acts of violence?

Have you ever engaged in the recruitment or the use of the child soldiers?

Have you, while serving as a government official, been responsible for or directly carried out, at any time,particularly severe violations of religious freedom?

Have you ever been directly involved in the establishment or enforcement of the population controls forcing awoman to undergo an abortion against her free choice or a man or a woman to undergo sterilization against his orher free will?

Have you ever been directly involved in the coercive transplantation of human organs or bodily tissue?

Have you ever sought to obtain or assist others to obtain a visa, entry into the United States, or any other UnitedStates immigration benefit by fraud or willful misrepresentation or other unlawful means?

Have you ever been removed or deported from any country?

Have you ever withheld custody of a U.S. citizen child outside the United States from a person granted legalcustody by a U.S. court?

Have you voted in the United States in violation of any law or regulation?

Have you ever renounced United States citizenship for the purpose of avoiding taxation?

DS 160 U.S. Visa Application

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