Elementor #58

Please enable JavaScript in your browser to complete this form.

DISCLAIMER: Before you begin this application, please read carefully this disclaimer and the terms and conditions related to this website. Once submitted to the Department of State, this application is NON-REFUNDABLE. Review specific instructions on the U.S. Embassy or Consulate website of your country and pay any Government fee accordingly. All information provided by you, or on your behalf by a designated third party, must be true and correct.

I understand that I may be subject to administrative or criminal penalties if I knowingly and willfully make a materially false, fictitious, or fraudulent statement or representation in a visa application submitted by me or on my behalf.

For site management, information is collected for statistical purposes. The Department of State Web Site uses software programs to create summary statistics for such purposes as assessing what information is of most and least interest or identifying system performance or problem areas. The following is the type of information collected about your visit to the web site: the name of the Internet domain from which you access State Department web sites (for example, "aol.com" if you are connecting from America Online) and the date and time you access our site.

For site security purposes and to ensure that this service remains available to all users, the State Department uses software programs to monitor network traffic to identify unauthorized attempts to upload or change information or otherwise cause damage. Unauthorized attempts to upload information or change information on this service are strictly prohibited and may be punishable under the Computer Fraud and Abuse Act of 1986. Information also may be used for authorized law enforcement investigations. Except for the above purposes, no other attempts are made to identify individual users or their usage habits.

This site is not a US Official Entity and is in no way associated with any US Embassy or US Consulate. We are a third party service that assists with the application process and cannot guarantee that your application will be approved by the Department of State. US visas can be obtained through traditional official channels without our assistance and without paying our service fees by visiting the state department website.

Unauthorized attempts to upload information and/or change information on these web sites are strictly prohibited and are subject to prosecution under the Computer Fraud and Abuse Act of 1986 and Title 18 U.S.C. Sec.1001 and 1030.

Furthermore, the Department of State assures that it will not

obtain personal identifying information about you through your use of this system, unless you choose to provide such information
share any information it receives with any outside parties, except where permitted by Section 222(f) of the Immigration and Nationality Act or, where applicable, the Privacy Act.

For More Information, Contact:

Public Communication Division
PA/PL, Room 2206
U.S. Department of State
Washington, D.C. 20520
202-647-6575

Please confirm that you have read and understand the disclaimer above.

I understand that I may be subject to administrative or criminal penalties if I knowingly and willfully make a materially false, fictitious, or fraudulent statement or representation in a visa application submitted by me or on my behalf.

I have read and understand the Disclaimer above and agree with these terms.

Please Choose Your Preferred Interview Location

Select preferred US Consulate for your visa interview.

Security Question

In order to access your application later, however, you will need: (1) your Application ID, and (2) the answer to the security question that you will choose on this page.

Answer

Travel Information

Purpose of Trip to the U.S.

US Travel Information

Give details of the address where you will stay in the US. The address may be that of a hotel or private residence.

Intended date of arrival in the USA

Intended Length of Stay in the USA

Enter the Number of Day(s), Week(s), Month(s), Year(s) ONLY THE NUMBER.

Please Specify

Given Mailing State

Address Where You Will Stay in the U.S.

Address Line 1

Address Line 2

City

State

Zip Code

Person/Entity Paying for Your Trip

Applicant Contact Information

Applicant Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone number

Secondary Phone number

Leave blank if you do not have a secondary phone number.

Work Phone number

Leave blank if you do not have a work phone number.

Confirm Email

Please enter a valid email address. It will be used to contact you about your application

Have you used any other phone numbers in the last five years?

Have you used any other email addresses in the last five years?

Mailing Address

The mailing address is different from the applicant address

Social Media

Do you have a social media presence? Select from the list below each social media platform you have used within the last five years. In the space next to the platform’s name, enter the username or handle you have used on that platform. Please do not provide your passwords. If you have used more than one platform or more than one username or handle on a single platform, click the 'Add Another' button to list each one separately. If you have not used any of the listed social media platforms in the last five years, select 'None.'

Social Media Provider/Platform

Social Media Identifier

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

Please provide the name of the platform and the associated unique social media identifier (username or handle) for each social media platform you would like to list. This does not include private messaging on person-to-person messaging services, such as WhatsApp.

Passport Information

Passport/Travel Document Type

Passport/Travel Document Number

Passport Book Number

Leave blank if does not apply

Country/Authority that Issued Passport/Travel Document

City of Issue

State/Province *If shown on passport

Leave blank if does not apply

Country/Region

Issuance Date

No Expiration

Expiration Date

Have you ever lost a passport or had one stolen?

DS160 Online Application

Personal Information

Document Information

Travel Information

US Travel Information

Financial support for your trip

Information about your travel companions

Previous US Travel

Applicant Contact Information

Social Media

Passport Information

US Point of contact

Family Information : Your Parents