DS160 Online Application

1 · Personal Information

Surnames *

Given Names *

Email Address *

Full Name in Native AlphabetLeave blank if not applicable

Have you ever used other names? (maiden, alias, religious…)

Yes No

Other Surnames Used

Other Given Names Used

Do you have a telecode that represents your name?

Yes No

Telecode Surnames

Telecode Given Names

Sex *

Marital Status *

Birth Day *

Birth Month *

Birth Year *

City of Birth *

Country of Birth *

Current Nationality *

National ID Number

Have you held any other nationality?

Yes No

Other Country of Nationality

Do you hold a passport for that country?

Yes No

Passport Number

Are you a permanent resident of a country other than your nationality?

Yes No

Which country?

U.S. Social Security Number

U.S. Taxpayer ID Number

2 · Passport Information

Document Type *

Passport Number *

Passport Book Number

Country that Issued Passport *

City Where Issued *

State/Province (if shown)

Issuance Date *

Expiration Date *

Must be valid 6+ months beyond your stay

Have you ever lost a passport or had one stolen?

Yes No

Lost Passport Number (unknown → blank)

Country that Issued Lost Passport

Explain what happened

3 · Travel Information

Purpose of Trip to the U.S. *

Have you made specific travel plans?

Yes No

Date of Arrival

Arrival Flight (if known)

Arrival City

Date of Departure

Locations to Visit in the U.S.

Street Address Where You Will Stay

City

State

ZIP Code

Intended Date of Arrival (approx.)

Intended Length of Stay

Person/Entity Paying for Your Trip *

Surnames of Person Paying

Given Names

Phone

Email

Relationship to You

Is the address of the person paying the same as your home address?

Yes No

Payer Street Address

City

State/Province

Country

Company/Organization Name

Phone

Relationship to You

Company Address

City

State/Province

Country

Are there other persons traveling with you?

Yes No

Are you traveling as part of a group or organization?

Yes No

Group/Organization Name

Surnames of Person Traveling With You

Given Names

Relationship with Person

4 · U.S. Point of Contact

Contact Person Surnames *

Contact Person Given Names *

Organization Name (if applicable)

Relationship to You *

Phone Number

U.S. Street Address

City

State

ZIP Code

Email Address

8 · Work & Education

Present Occupation

Primary Occupation *

Present Employer or School Name *

Street Address (Line 1)

Street Address (Line 2) — optional

City

State/Province

Country

Phone Number

Start Date

Monthly Income in Local Currency (if employed)

Briefly describe your duties

Previous Employment

Were you previously employed?

Yes No

Employer Name

Employer Street Address

City

Country

Telephone

Job Title

Supervisor's Surname (unknown → blank)

Supervisor's Given Names (unknown → blank)

Employment From

Employment To

Briefly describe your duties

Education

Have you attended any educational institution at secondary level or above?

Yes No

Name of Institution

Street Address

City

Country

Course of Study

Date of Attendance From

Date of Attendance To

Photo Upload

Passport-Style Photo * Recent photo on a white background, 2x2 in (51x51 mm), JPEG or PNG, max 5MB.

Photo requirements — please review before uploading:

Size: 2 x 2 in (51 x 51 mm)
Head height between 1 and 1 3/8 in (25-35 mm), from chin to top of head
Recent photo, taken within the last 6 months
White or off-white background
Face the camera directly, full face in view
Neutral expression or natural smile, both eyes open
Color photo, normal everyday clothing
No glasses, hats/head coverings (unless worn daily for religious or medical reasons), or wireless headsets

10 · Security & Background

⚠️Answer all questions honestly. A YES answer does not automatically mean visa denial, but you may be required to appear before a consular officer to explain.

🔑 Save your answer to the security question below. You will need it to check the status of your DS-160 application.

Security Question *

Your Answer * Write this down — you will need it to check your application status.

11 · Review & Confirm Details

Uploaded Photo

Signature

Applicant E-Signature * Type your full legal name. This will serve as your electronic signature.

I certify under penalty of perjury under the laws of the United States of America that the foregoing is true and correct. I acknowledge and agree that entering my name in the signature field above legally replaces my physical signature.

12 · Payment Information & Confirmation

Payer First Name *

Payer Last Name *

Payer Phone Number *

Payer Email *

Payer Passport Number

Billing Address

Street Address *

Address Line 2 (optional)

City *

State/Province/Region *

ZIP/Postal Code *

Country *

Confirmation

I confirm that the information provided in this form is true and accurate to the best of my knowledge. I have read and agree to the Disclaimer, Terms & Conditions, and Refund Policy. I understand that this transaction is non-refundable. This site is not a U.S. government entity and is not affiliated in any way with any U.S. Embassy or Consulate. If a cardholder falsely reports a transaction as fraudulent and requests a chargeback for an application fee, this will be reported to the Embassy and may result in the cancellation of any visa appointment already scheduled. I also understand that, due to high demand, most U.S. Embassies are experiencing significant delays in scheduling appointments, and that we have no control over the Embassy's appointment schedule. By submitting my payment information, I authorize our agency to charge the payment method provided for the requested services and any related fees or expenses, and I agree to comply with the terms of my card issuer's agreement. This applies to any fee charged, incurred, or paid by our agency for the preparation and/or submission of any document requested by me, whether or not the submission is ultimately accepted.

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