Online Nonimmigrant Visa Application (DS-160) Apply For a Nonimmigrant Visa mice Tonltp Language: Engish [View ToolTip Hep] ‘Most of this application has been translated. To see the translation pomt your mouse over any sentence on the page. ‘Welcome! Get Started. On this website, you can apply for a U.S, Select a location where you will be applying for this visa hienimmigrant visa. Filing out the eppliction on [> ~ our site is the fist step in the process. After @ [SEECTONE ‘ you submit your application, you can move on to the next steps, such as sigring up for an interview, Important: Before You Start BULL a 1 Lear about oes of visas Select location then select an apaliction that you previously 2. Lstof DacumentsandInformaton you wil |) SveHon your computer. need | Cau Cam 3. Browser Requirements You will be asked for your application 1D and answer a 4, How to complete the application security question. Oh peap an south yours Io application, Note that under U.S. law (22 CFR. 41.103) you must electronically sign and submit Additogallnformation your own application unless you qualfy for an exemption, Even if someone else heloed you» Read more about U.S. visas at travel state.gov, complete the application, you (the applicant) Visit the website of the U.S, Embassy or Consulate, must cick the "Sign Apolication” button, or your application may nat be accepted. **Please be patient as you use this form. Dawnlead times may vary depending on your internet connecton speed.**Online Nonimmigrant Visa Application DS-160) Retrieve a DS-160 Application Your Application 1D is [=A007 Retrieve Application cance! ro) U.S. DEPARTMENT o Corrie ee mn uc) Online Nonizumigrant Visa Application (DS-160) ¥ Geiting Started 5 Retrieve a DS-160 Application ‘Your Application 1D is: Security Questions Firat 5 letters of Surname ‘Year of Birth What is the given name of your mother's mather? Retrieve Application cancel Help: Navigation Buttons() LORS DAD Cena SSO (Ouline Nonimenigrant Vice Apslisetion (DS-160) Application 1D AAOOIWXWAY Personal Information 1 Foam NUMBER; 08-260 EXPIRATION DATE: C4/30/2014 ESTINATED BURDEN: 75 MIN NOTE: Detocn this pane must match the infrrnetion as itis writen in your passpert (ea, FERNANDEZ GARCIA) (ea, 2uan MIGUEL Ful tart in Native alcbal es Nat appli Hop: Surnames Enter ll surnames es listed in your passport, IF only one name: In your passport enterthat Surname, Hap : Greate ct include a ¥en nam pl Have you ever used cther names (ie, maiden, religious, professional, alla, et)? a Yes No Hap: Once other nemes uted inehide your maiden name, regi been known bin the oest of any other name which you are known by or have fame, otofeesional Doycuhavea a code thet represents your narre? Hsp Teode Teleoo wrsbers that rep cn Reman alphabet ramos og ale Female arial sence a . Date and Flace of Birth Date of Bith(Format: DO-MlM-Y¥¥¥) city of ith State/Province of Birth oes Not Apply Place of girth Help: Date of rth 11 day o¢ month fe unknown, enter as shown in passport Hap: Pace oF etn Select the name that le curently in use for the place where you were born Publ reporting burden fr thie callacton ef formation ie astinatal io average 75 minutes per rerpense, include Hime required for sarehing ‘Stotng ata soutea, gathering the necessary documentation, providing ths informaten andor dacumantsrequrad, and rian ing the na {alton You do net have to supply tis formation unless this coleson displays a carey vold OMB central number. You have comments on ‘he accurecy of he burton strats and/or recommancations for rdueng ky panos san them A/ISS/ DIR, Room 2400 SA-22, US. Department of tate, Washington, DC 20522-2202, 1A Section 222() proves that the record ofthe Oapartmant of stabs and of aplomate and consular offices ofthe Untad states pertaining tothe Issuance and refusal of vias or permits to ener the Unita States shall be considered configental and shall be used only forthe formulae, “zrenament,adminltrtion, or enforcement of Se immigration, natonalty, ana ober is of te Und Stats, Care copes of such records may i mde nubile toe court proved the cour cares the tha rformation conained i sich records edad incase panding belo te Oure.S, DEPARTMENT 0 Oxtine Nonimmigrant Vise Application (D3-160) “Appliostion tD AAOOTWXW4F Personal Information 2 Nationality Do ycuhold or have you hold eny nstionalty stherthan the ons inceated above on nationality? oo Navin Ieentiteation lumber — 5 Dove Nat Apply US Sodal Seeurty Number (I -F a base net Apel US Tammeyer ID Number —— wm Does Nat Aocly Hop: Menication Numbers 2 uniaue number sel Security Mut ‘The U:S. Goverrment provides urigus numbers to those© LORMAN Eg STN (Online Nonimmigrant Vise Application (DS-160) ‘Applicaton 1D AAOOIWXW4F Address and Phone Information Home Adceess street Address (Line 1) street Address (Line 2) FOstonat ey State/Province Ld Does Not poly Postal Zone/2 Code C1 Dose Net Apel country Malling Address 1s yeur Maing Address the same as your Heme Aiddress? go Yee No Phone Primary Phone Number dart Phone Number are Not Apa ‘Wer Phare Number Te Does Nat poly Hp: Plone provide a pcmary phone numer, The primary phore rumbar shculd ko the phone numer st which you are mostly to be pts end be a lend ine or callie number. I you have an additend land ine ae 9 elar/matile numer glnsse Email Addkess mall accrese Dose Nat Apel - Dad PeseaLOAD TONE UNG STO Online Nonimmigrant Visa Ap lication (DS-160) AgplicainID AADOIWXWAF Passport Information Hop: Passpord Travel Document Nunbor Entar dh iorrtion on the aval dog rner-You wil bo sng wien traveling tthe U'Si-Your travel document dhould bea val, Unexpired passpert ar other vad, unexpired document tion thas suficierk ta establish your Mentity end naionalty Posspat/Troel ocurent ype ® — RECULAR asspot/Trael Dement Number lp: Passport Book Number fr contr numb: Book Number on ort Boal Number 29 your pad fed your ing authority you af unable to determibe whether or not your passport cantains & Passport Psspert Book Humber 3 Doze Not apaly - Courtry/tuthority that sued Pessport‘Travel Doeument PERU a \yhere vse the Paseport/Travel Qaoument Larued? ty State/Province “IE shown on passport Ccourtry PERU a Issuance Date (rormat: OETA, lap: Eypiruton Date tn most cases your parcpon your arrvaln the United Stats yet Document must have at leact sie months of aldey nevane the ate of your vies application and/or Expiration bate o DoesNet Avely Have you ever lost» passport orhad ene stolen? ao Yes No(Sd) US. IoD CU ag STN Online Nonimmigrant Visa Apslivation (DS-160) Travel Information NOTE: Provide the following iefermatin concerning your ave plans. FPravide te falaming information: naps Prip 3 evis ones oe . specty(O) — excHanE wstt0R 6) Il Add Bosthar Have you made soedtic travel plans? a Intended Date of arrival (Format; Ob-HM-rrrO, Intended Lenath of Stay ins. @ 3 Mths) Hop: daria Pane HF you ars uncie of your tr plane, please provide an asimate ada here You Wil Stay inthe US Street Adsrss (Line 1) Street Address (Lins 2) "Ostanst ‘ey 22 ZIP Cade (it kno tea siz) Person/Entity Paying for Youeriin | ‘er Perean Provide the felling information Surnames of Parson Paying for Tip (ea,, FERNANDEZ GARCIA) Gwen Marnes of Person Paying for Te Telephcre umber mal Adsress| CS oes Not Apply Gu. , emailadcress@ex am ple.cou Relationship ta You o PARENT a Application D AADOIWXW4E Is the address of the party paying “or your trip the same 25 your Home or Ma ling Address? oa Yes No Bask Pastpert News! Irave Companion’PTD UT RT SST Online Nonimeigrant Visa Application (DS-160) Applica 1D AADOIWXWAF Travel Companions Information NOTE: Provide the folowing travel companion inrormaton, Persons iravaling with you Are there other persons traveling with you? oo Yes No Help: Traveling with Others You should ansiver Yes te this queston if you are traveling with family, as part of an organized tour, or as part of a performing group or athletic team. You de not need tc list individuals who are traveling with you for the purposes of employment with the same employer. Are you traveling as part of a croup or organization? oo Yes No Enter the name of the group ycu are traveling with Group Name |ATENEA PROGRAMAS DE INTERCAI/BIO | Back Travel Next Previous US. TrevelLOAM DTI NS NP SSS (Online Nonimmigrant Visa Application (DS-160) Applionsen td AAOOIWXW4F Previous U.S. Travel Information. NOTE: Provido tho following previous U.S; travel inforraticn. Provide compte and accurate information to all qusctions that racuro an explanation Have you ever been inthe S.7 oa Yes No Provide information an you! ate arved Da you or did you ever hold a U.S, Driver's License? ao Yes No Heb Previous U.S Visits 1F you are unsure about when you visited the U.S rovide 9 best estimate Have you ever been issued aS. Visa? oo Previous US sas Date Lar visa Nar jesus, (Formats OHM ies Number ee | Do Net naw sre you azphing for the same type of ea? oa No fre you acplying in the sare country where the vise above vos issued and i this country yaur principal country af residenco? oa Yes MeHave you been ten-printes? og Has your U.S. Viea ever been lst or stolen? oo Yee No Has your U.S. Visa ever been cancelled or revoked? ag Yer No eps Vea Number Enter the 8g number that is displayed in re on the lower right hand sie of your visa If your previous visa was a Border Crossing deepen 12-dight number ofthe firs line of the machine readable sone Ten-printed means that you have provided fingerprint forall your fingers, as opposed to having provided only twe fingerpr Have you ever b the port of entry? n reused 4 U.S, Visa, been refused admission to the United States, or withdrawn your plication for admission at aa Yes No Explain = 2 Hos enyone ever fled an immigrant petition on your behalf with the United States Cizenship and Immigration Services? oa Yes No explain = oeU.S. DEPARTMENT of S7A a (Ouline Nontmenigrant Vise Apgliseticn (DS-160) Appliowion ty AAOOTWNW4F US. Point of Contact Information Contact Parson or Orgari2aton inthe United Statoe contact Parson Surnames i I o Oraanizstion Name tr a Do fst Kaw Relationship te vou Hep: Contact ‘Your US, Paint of Contact ean ke en individual in the US, wha krews you and oan verify, i necescory, your identity. Ifyou do not personaly Inow anyone inthe ls. you may entar the narye ofthe seers, compent. er erganisatien sou sian 9 "sh rng your top Address and Phone Hunrber of Poin of US. Steet Adetoss (Line 2) U.S. Strost Adeross (Line 2) FOpbonst ey ZIP Cade if kromn (ez,, 5505S or S5E55-S565) ao pely ea \dress@'example.carm} Teck Prepare US Te Ne Fant© LOAM DIST N SNP SSS ON Online Nonimmigrant Visn Application (08-160) ajpueave A AOOIWSWAP Family Information: Relatives NOTE: Please provide the flowing information concerring your biolegical parents rf you are adepted, please pravide the allowing information on your adastive parents Father's Full Name and Date of Birth Surneres Ir (ea, Hermandee Garda a i (©, ddan Miguel o 1 fist Kran Date of Birth (Faimets O”-HI i yourtaber nines eo Yes No Mother's Full Name and Date af Birth Surnames i (eg, Hemmandes Garcia a r (ea Juanita Miguel) 5 Do fst Kraw pate of pith O | NM) (Fount Do net kno 1b yeurmetherin tho US2 ao Do youhave any immediate relatives, ret including parents, inthe Urited States? oo Heb: Inmediaie Relatives fe 1 faneé/faneée, sause (husbandt), child (2on/dauahter, or aoling (bro Tech Ue Coma Tag enieoeen Tene sisteriS g) OAS pay yeu” while 2 "25 answer dase nct utomatcally signfy indigility for @ vise, ou enswer YES you may be reacired to personally arpeer before a consular dice, Da ycu sek te engage in espionage, sebotage, escort control valaions, cr any ather legal acvity wile in the United States? 9 Yee No a yeu seek to engage in terreriet activities while inthe Urited States or have you aver engaged in terovst activities? ag Yee No Have you evar or do you intane to provide fnancial aezietance or cher support te tara ate or tavoisterganizaticns? os Yes No sre you a meraber or representative of eterroit organization? a Have you ever ordered, insted, committed, assisted, or ethenviso portoipated in conccids? og Have you ever commited, erdered, incited, assisted, or thenvise aorticipated in torture? og vee Ne Have you committed, creved, incited, assisted, or cthensise participated in extrajuici kilings, political ilings, or other acts of sialenee? og Yes No Have you ever engaged inthe recruttment orthe use of cil sldiers? of Have you, while sercing as.2 govemment afcial, been responsible for oriractly cared cut, a any time, palcularly severe vialatins of raligous freedom? o8 Yeo Ne Have you ever been ciety involved in the establihenent or entorsoment of papulation centrale forang a weman to undergo an abortion agains: her free choi or 2 man or a waren ts underse sterilization against his or her foe wil? oa Yee Ne Have you ever been direy involved in the coorcive transslartston of human eraans or bodily tissue? of Yee Ne Dank Seouiyad roundPaTz Td SecuibyBatoeand FattLOAM DITOR SNP SSO Online Nonimmigrant Visa Application (DS-160) “Applioston 1D AAOOIWXW4E Security and Background: Part 4 NOTE: Provide the folowing security and beckyraund information, Provide complete and accurate fnformation to all questions that racurre an oxplanstion. A visa may nst bs esusd to persons who aro withn spostic oztazenss defined by la az admascils ‘0 the Linted Staves eccept whens usta s chleined in advance) Ate any ofthe fcloning applicable ta you? while aYES answer dass net automatealy sienfy inscility fora viea, you answer YES yu may be required to parsanally appozr befaro a conclar cicer, Have you ever been tho subject of a reraval er deportation hearing? a Have you ever saught to obtain er assist others to obtain a visa, entry inta the United states, c¥ any ether United States immigration hhenent by fraud or wilful misrepresentation ar ather urlawfu| means? a8 Yes No Have you failed to attend a hearing on removsblity or inadmissibilty within the last five yaers? ag Yes No Have you ever been unlanfully present, overstayed the araunt of ire grented by en immigration afciel or otherwise wolated the terms da U.S, vie? Dank Seouiyeag gouNaPaTS Tie Sennen TENTFaLSU.S. DEPARTMENT of, STAT Online Nonimmigrant Vise Apslisetion (DS-160) “AgplistionD AAOOIWXW4F Security and Background: Part 5 NOTE: Provide the following security and beckgraund information, Provide complete and accurate information to all questions that Faquire an explanation..A nea may net de suse to aeteons who are withn spastic ozzagenas aefincc by ly ae madmastsle 0 the Linted States except when 2 vctra is cbtained in advance). Are any of the felloning epplicable ta you? While a YES ansier dass not automatealy sienfy insigility fora visa, you answer YES yu may be roq.ired to parsorally appozr before a conclar cricer. Hove you ever nthield custody of @ US czen dild autsie the United States from a person granted legal eistody by oS. court? o8 Yee Ne Have you voted in the United States in vation of any lan or regulation? o8 ves to Have you ever rencunsad United States citizenship far the purposss of aiding taxation? ag Yes No Have you attended » public lerentary schoal on student (F) status ora public zecondary sehocl after November 30, 2996 without reimbursing the sches”™ a9 Back Soousbea woundPatt Tew coeeicteras esPa eg SST (Culine Nonimmigrant Viea Apelication (DS-160) Applicetico 1D AADOLW XW4F Additional Point of Contact Information. NOTE: You have indicated that you will bo studying in some capac whil in the United States, List ot least two contacts in your country of residence nha oar very the informatizn that yeu have provided an his applicstion. Ue ne Hist immeclare famly memers cr thar relatives, Postal ofce bax rumbors aro unaccortatl, sumemes @von Names ‘Street Adsress (Line 1) Sireet Aucess (Line 2) #qpdunst by State/Province a ‘oes Not Analy Postal ZonesZiP Cade o Doss Not Apel country Telephone Number ‘Does nat asl mal adress Add An ther pemers ‘sven ames Street Adsress (ine 1) Street Adcress (Line 2) FOntonss ty Seate/erasince i Does Nat Analy Postal Zone/ZiP Code oO Does Nak Aly country “Telephone Number a Does ft Aocly Emel Address a Does Not Ap aly (g., emalladares: Aad Another Remove Dash Soeur and Backyard jezample.ccm) Tem Seve.S. DEPARTMENT of. Online Moniiamigrant Vise Apslivation (DS-160) -Applicain 1D AAOOLWXW4F SEVIS Information NOTE: Yau have indicated thatthe purpose of yourtip to the U.S. ieta be a student or exchange vsitr. Prove the falloning information reaarding the insttution at which you intend to study, stvIs rogram Numb er Do you intend to study in the U.S 7 a Bae anal Oa Tem TROT& U.S. DEPARTMENT of STA a Upload Photo Photo Quality Standards In order to oncuro the hichact qualty photos sill be used inthe fins printed travel decumort, the Deparment of Stato has ereated a hide for you to use when cresting anduplosding your chotos [seo gata gully sandars wuidel, Seles Your Phot lick the "rouse" button and choose 2 JPEG format image (ie., jpg fle typa) that Ie 240 Ke or les in laste Selected Photo: Pee ater) hes =m This site js managed by the @umau of Consular afar, U.S, Department of State. External links to cther Tternet sites should not be construed az an endarsoment ofthe views contained therein + Copyright Information + Disclaimers + Paperwork Reduction ctApilicaton ID AAODIWXNW4E Sign and Submit 1 necetsaly mean thet your aoolicaton Dorconnal ave ravewod the appleton Bock “sgn a: eur knovladgs anc bolof. Tho sub sson sf an spoiostien conta re Acpliation® you ar cle crenosly slong ths spslistion You ae quit w lacverically eign yeur application sfstiee_ even eve agpmtien "as hon sropared by somenne ctor then y cue Yr eect iy fase or mislead ta Aatorarts may roa nthe pormanent rofuc| of United States, A delaratons mado mths spplcaben re unewon dedarstons made under onde ct Enforeersens purnases The pnotorspr ts You provide with your asplst on may Be used for emplowmmenevenfesean or ater. a0 Human Trafficking Prevention Pursusre to Socien 202 f the william witerorce Tracing vistins Petection Reauthovzation Act of 2008 you are renifed to recive 9 any ofan frm onel porphin the ega atts ne ressurees ot alens apching ter emsinyment cr eeueston-hared neni otenes W506, Pease eas the ear hie creh)y, We stanly encourage routo pret 9 copy oF pamphlet anccey € with You F your vis Is Grated an you Wave tone United Sines, Mlle Wslare Taiicins linn Piacoa Reatizalion Bo of 2090 Paula ‘eet that have viened anavead the Wiliam wibertore Tafceng Vaims Pratection Neauthorsaten acto 2008 Pamphlet. x Preparer of Apolicaion ie anyone aes yu ning cut this selcation? o@ ESignsioze Loertity under penaty of enurs under the nus of the United States of evisn thot the forcing iste and comer ter your PassparTravel Document Number: Enter the code a ehown a (ck tne button below to electronically sign your application: eee] ea)