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All entries on the application must be filled, i.e. contain answers to the questions set. Make sure the application is completed accurately. To finalize your application hit the Continue key at the bottom of the application page, then print it out. The full application form has three pages. Usage of a laser printer is preferable. Usage of an ink-jet printer does not ensure the necessary quality of the printed barcode, which may cause extension of the visa processing time.

Upon completion and printing out your application form you may proceed to your family members’ visa applications. To save time, just press the Back key. Getting back on page DS-156, press the Generate Family Duplicate key at the bottom of the page. The system will transfer part of information from your application to the new application form automatically.

For you convenience, you may use translation of entries for DS-156 application form below.

Attention! Please complete a visa application form on line. Your answers must be in English and must use English characters.

1. Passport Number
   
   No spacing, hyphens, parentheses, or the N signs. Example: 511234567.
2. Place of Issuance: City, Country, State/Province
3. Issuing Country
4. Issuance Date (dd-month-yyyy)
5. Expiration Date (dd-month-yyyy)
6. Surnames (As in Passport)
7. First (As in Passport) and Middle Names
   
   For transliterating middle names please use the instruction attached.
   
   
8. Other Surnames Used (Maiden, Religious, Professional, Aliases)
   
   If you have never used alias last names, please leave this entry blank.
   
   
9. Other First and Middle Names Used
   
   If you never used alias first or middle names, please leave this entry blank.
   
   
10. Date of Birth (dd-month-yyyy)
11. Place of Birth :City, Country, State/Province
12. Nationality
13. Sex: Male Female
14. National Identification Number (If applicable)
15. Home Address (Include apartment number, street, city, state or province, postal zone and country)
16. Home Telephone Number, Business Phone Number, Mobile/Cell Number, Home Fax Number, Business Fax Number, Pager Number
    
    Telephone, fax, pager numbers as well as city codes should be entered without spaces, hyphens and or parentheses. Example: 4951234567.
    
    
17. Marital Status: Married, Single (Never Married), Widowed, Divorced, Separated
18. Spouse's Full Name (Even if divorced or separated. Include maiden name.)
19. Spouse's DOB (dd-month-yyyy)
20. Name and Address of Present Employer or School
    Name: Address:
21. Present Occupation (If retired, write "retired". If student, write "student".)
22. When Do You Intend To Arrive In The U.S.?
    
    If you are unsure about your departure date, please indicate the closest possible date. Example: If you are planning to travel in January but do not know the exact date, indicate January 1 as earliest possible date of your departure.
    
    
23. E-Mail Address
24. At What Address Will You Stay in The U.S.?
25. Full names and Telephone Numbers of Person in U.S. Who You Will Be Staying With or Visiting for Tourism or Business
    
    Full names, Home Phone, Business Phone, Cell Phone
    
    Telephone numbers including city codes should be entered without spaces, hyphens or parentheses. Example: 203111234567
    
    
26. How Long Do You Intend To Stay in The U.S.?
27. What is The Purpose of Your Trip?
28. Who Will Pay For Your Trip?
29. Have You Ever Been in The U.S.?
    Yes No
    When?
    For how long?
30. Have You Ever Been Issued a U.S. Visa?
    Yes No
    When? Where?
    What type of visa?
31. Have You Ever Been Refused a U.S. Visa?
    Yes No
    When? Where?
    What type of visa?
32. Do You Intend To Work in The U.S.? Yes No
    (If YES, give the name and complete address of U.S. employer.)
33. Do You Intend To Study in The U.S.? Yes No
    (If YES, give the name and complete address of the school.)
34. Names and Relationships of Persons Traveling With You
35. Has Your U.S. Visa Ever Been Cancelled or Revoked? Yes No
36. Has Anyone Ever Filed an Immigrant Visa Petition on Your Behalf? Yes No
    If Yes Who
37. Are Any of The Following Persons in The U.S., or Do They Have U.S. Legal Permanent Residence or U.S. Citizenship?
    
    Mark YES or NO and indicate that person's status in the U.S. (i.e., U.S. legal permanent resident, U.S. citizen, visiting, studying, working, etc.).
    
    Yes No Husband/Wife________ Yes No Fiance/Fiancee ________
    
    Yes No Father/Mother________ Yes No Son/Daughter_________
    
    Yes No Brother/Sister________
38. IMPORTANT: ALL APPLICANTS MUST READ AND CHECK THE APPROPRIATE BOX FOR EACH ITEM.
    A visa may not be issued to persons who are within specific categories defined by law as inadmissible to the United States (except when a waiver is obtained in advance). Is any of the following applicable to you?
    
    
    • Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty or other similar legal action? Have you ever unlawfully distributed or sold a controlled substance(drug), or been a prostitute or procurer for prostitutes?
      Yes No
    • Have you ever been refused admission to the U.S., or been the subject of a deportation hearing or sought to obtain or assist others to obtain a visa, entry into the U.S., or any other U.S. immigration benefit by fraud or willful misrepresentation or other unlawful means? Have you attended a U.S. public elementary school on student (F) status or a public secondary school after November 30, 1996 without reimbursing the school?
      Yes No
    • Do you seek to enter the United States to engage in export control violations, subversive or terrorist activities, or any other unlawful purpose? Are you a member or representative of a terrorist organization as currently designated by the U.S. Secretary of State? Have you ever participated in persecutions directed by the Nazi government of Germany; or have you ever participated in genocide?
      Yes No
    • Have you ever violated the terms of a U.S. visa, or been unlawfully present in, or deported from, the United States?
      Yes No
    • Have you ever withheld custody of a U.S. citizen child outside the United States from a person granted legal custody by a U.S. court, voted in the United States in violation of any law or regulation, or renounced U.S. citizenship for the purpose of avoiding taxation?
      Yes No
    • Have you ever been afflicted with a communicable disease of public health significance or a dangerous physical or mental disorder, or ever been a drug abuser or addict?
      Yes No
    While a YES answer does not automatically signify ineligibility for a visa, if you answered YES you may be required to personally appear before a consular officer.
39. Was this Application Prepared by Another Person on Your Behalf? Yes No
    (If answer is YES, then have that person complete item 40.)
40. Application Prepared By:
    NAME:
    Relationship to Applicant:
    Address:
    Signature of Person Preparing Form:_____________________
    DATE (dd-month-yyyy)__________________________
41. I certify that I have read and understood all the questions set forth in this application and the answers I have furnished on this form are true and correct to the best of my knowledge and belief. I understand that any false or misleading statement may result in the permanent refusal of a visa or denial of entry into the United States. I understand that possession of a visa does not automatically entitle the bearer to enter the United States of America upon arrival at a port of entry if he or she is found inadmissible.
    
    APPLICANT'S SIGNATURE____________ DATE (dd-month-yyyy) ________

Privacy and Paperwork Reduction Act Statements

INA Section 222(f) provides that visa issuance and refusal records shall be considered confidential and shall be used only for the formulation, amendment, administration, or enforcement of the immigration, nationality, and other laws of the United States. Certified copies of visa records may be made available to a court which certifies that the information contained in such records is needed in a case pending before the court.

Public reporting burden for this collection of information is estimated to average 1 hour per response, including time required for searching existing data sources, gathering the necessary data, providing the information required, and reviewing the final collection. You do not have to provide the information unless this collection displays a currently valid OMB number. Send comments on the accuracy of this estimate of the burden and recommendations for reducing it to: U.S. Department of State, A/RPS/DIR, Washington, DC 20520.