| 1.Passport Number
Applicant's passport number.
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2. Place of Issuance:
City: City of passport office where the
passport was issued.
Country: Country where the passport was
issued.
State/Province:State/Province where the
passport was issued.
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3. Issuing Country
The country of Passport. |
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4.Issuance Date
Date of Passport Issuence. Provide date
in simolified format example : 12-DEC-1999.
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5 .Expiration Date
Date of expiry of Passport. |
| 6. Surname
Applicant's surname or lastname.
Note: Visa applicants should indicate clearly in their Last Name and Given Name. Its often seen in the case of South Indian names that passport issuing authorities write the whole name in the Last Name field.
Applicants should check their passport and if the whole name is given in one line, they should get the same changed from passport office before applying for a visa.
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7. First and Middle Names
First and Middle Names(As in Passport):
Your first and middle name. Also called
Given Name. In Indian passport, write everything
that is written in second line in name. |
8. OtherSurname used Used:
Fill this Only if you have any other surnames in past. |
9. Other First and Middle Names Used:
Fill this Only if you have any other names in past. |
10. Date of Birth (dd-mmm-yyyy):
Applicant;s date of birth as per passport. |
11. Place of Birth:
Place were you were born. As per your passport. |
12. Nationality:
Applicant's citizenship. |
13. Sex:
Applicant's gender, male or female. |
14.National Identification Number:(if applicable)
This is not applicable If you are Indian Citizen
, or any other country where there is no National
Identification number. Wirte "None"
or "N/A" . |
15. Home Address:
Your complete current home mailing address including
apartment number, street, city, district,
state, zip code and country.
This may differ from your permanent address
mentioned in the passport.
This will be the address where consulate will
do all the communication with you including
sending the passport after visa stap etc.
* Note: For those
who stays in USA / or any other country and
applying for US visa/ restamp sould write
the present address of home country.
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16. Home Telephone Number
Business Phone Number:
Mobile/Cell Number:
Fax Number:
Business Fax Number:
Pager Number:
Provide this infiromation appropraitely, where
ever not applicable write None or N/A.
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17. Marital Status:
Check mark the appropriate box applicable
to you. |
18 .Spouse's Full Name:
Sspouse full name if applicable. |
19. Spouse's DOB(dd-mmm-yyyy):
Spouse's date of birth. |
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20. Name and Address of Present Employer
or School:
- If you are employed write complete name
of company/firm and address where you
work.
- If you are self employed, write name of business and address where
your business is located.
- If you are retired, and do not
work, write 'N/A'.
- If you are a student write name and
address of school/college.
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21. Present Occupation
(If in Job write employed, If retired, write "retired". If student, write "student".):
Write your current occupation with meaningful and specific details occupation:
e.g. "Systems Adminstarator" , "Project Manager- Software development" etc.
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22. When Do You Intend To Arrive In The U.S.?
Provide your tentative date of travel to USA.
Examples:
Fiest week for Feb 05. |
23. Email Address:
Your email address, if any . |
24. At What Address Will You Stay in The U.S.?
Write the complete address where you will be staying in USA. If you will be staying with your relatives providet that address OR if you will be staying in a hotel provide that address.
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25. Name and Telephone Numbers of Person in
U.S. Who You Will Be Staying With or Visiting
for Tourism or Business :
If you are going to staying with relative write his/her name and their
telephone number. |
26. How Long Do You Intend To Stay in The
U.S.?
If you are applying for visitor visa provide a Tentative length of visit : Examples : 4 months , 6 months.
If you are applying for work visa H or L : Till the expiry of approved petition. |
27. What is The Purpose of Your Trip?
Provide this information appropriately , if you are applying for work visa like H1, L1 write "Employment".
If you are applying for student visa write "study".
If you are applying for Visitor/Tourist visa write "Tourism".
If you are going on Business trip write "Business trip". |
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28. Who Will Pay For Your Trip?:
If your trip is sponsored trip write the name person who provided you afidavit od support.
If you are employer is paying for expenses write : "Employer".
If you are paying yourself , write : "Self". |
29. Have You Ever Been in The U.S.?:
Fill appropriately , if you had been to US check Yes else check No.
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30. Have You Ever Been Issued a U.S. Visa?
Fill appropriately. |
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31. Have You Ever Been Refused a U.S. Visa?
Fill appropriately.
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32. Do You Intend To Work in The U.S.?
Depends on the visa type you are applying for.
For visitor/ Tourist visa applicants, this answer
would be NO.
For Business Visa the answer would be "No"
For student the answer would be "No"
For work visa like H1, L1 etc the answer would be "Yes" and for the dependts of these visa like H4 or L2 the answer would be "No".
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33. Do You Intend To Study in The U.S.?
Applicant for student visa should write "Yes".
Others should write "No".
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34. Names and Relationships of Persons Traveling
With You:
Name and relatiosnhip of the person who will be travelling with you If any.
Example, husband wife should write each others name if they will be travelling togather.
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35. Has Your U.S. Visa Ever Been Cancelled
or Revoked?
Answer appropriately. Must provide correct information. |
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36. Has Anyone Ever Filed an Immigrant Visa
Petition on Your Behalf?
This is only applicable if any one filed a Green Card for the applicant. If not wite "None" or "N/A" |
37. Are Any of The Following Persons in The
U.S., or Do They Have U.S. Legal Permanent
Residence or U.S. Citizenship?
Check mark appropriately on YES or NO. Write person's
status in the U.S. (i.e., U.S. permanent
resident, U.S. citizen, studying,
working, etc.).
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38. Important Questions:
All of these YES and No type questions to check for the various legal grounds.
For most people, answers to these questions
would be 'No'.
However if any of these |
39. Was this Application Prepared by Another
Person on Your Behalf?
If this application is prepared by other
then the applicant him/herself , the answer would be 'Yes' . |
40. Application Prepared By:
Depends on this previous questions, If the answer to question. 39 is 'Yes', the name, relationship( if any), complete address, signature and date of the preparer will come here. |
41. Sign and date the application.
Siganture of the aplicant and Date. |
