Application ID

AA001FVKXD

Guide for Completing DS 160 form.

Important: - All info provided should be accurate & applicable to individual.
Changes are not possible once application is submitted. Misrepresenting info
could lead to consequences.

Personal, Address, Phone, and Passport Information Section

Name Provided: XYZ, Abc
Full Name in Native Language: DOES NOT APPLY
Other Names Used: As applicable
Sex: MALE/Female
Marital Status: As applicable
Date of Birth: 31 JANUARY 1976
Place of Birth: GWALIOR , MADHYAPRADESH , INDIA
Nationality: INDIA
Other Nationalities: NO
National Identification Number: DOES NOT APPLY
U.S. Social Security Number: As applicable (for Visa renewal cases)/Does not apply (for the new L1
Blankets)
U.S. Taxpayer ID Number: DOES NOT APPLY
Home Address: Current residence address city where you are working
City: SECUNDERABAD
State/Province: ANDHRAPRADESH
Postal Zone/ZIP Code: 500015
Country: INDIA
Same Mailing Address? (as applicable)
Home Phone Number: As applicable
Work Phone Number: As applicable
Work Fax Number: As applicable
Mobile/Cell Phone Number: As applicable
Email Address: As applicable
Passport Number: As applicable
Passport Book Number: DOES NOT APPLY
Country/Authority that Issued Passport: INDIA
City Where Issued: (As applicable)
Country Where Issued: (As applicable)
Issuance Date: 03 DECEMBER 2009
Expiration Date: 02 DECEMBER 2019
Have you ever lost a passport or had one stolen? (As applicable)
Travel Information Section
Principal Applicant? YES
1. Yes - for applicant.
2. No for dependents

Purpose of Your Trip to U.S.

Purpose (1) : OTHER (check dropdown)
Other - Specify: intracompany transfer (L) (check dropdown, provide as applicable)
Specific Travel Plan? (say NO if not confirmed)
Date of Arrival in U.S.: 28 FEBRUARY 2010 (anticipated date of travel)
Date of Departure from U.S.: Latest date of departure from US, (if you have been in US before)
The Location you plan to visit in the U.S.: (based on client location provide a place of stay or hotel
address in the city/town where you will be working. Do not mention client office address)
Location (1): e.g. MILPITAS
Address where you will stay in the U.S: 620 IRIS AVE
APT 405
SUNNYVALE, CALIFORNIA 94086
Person/Entity Paying for Your Trip: select Company/Organization
Name of the Company: Genpact, LLC
Telephone #- As Applicable (can give managers landline #)
Relationship to you: Employer
Address of the Company: 40 Old Ridgebury Road, Danbury, CT, USA 06810
Other Persons Traveling with You: (as applicable)
If Yes:
Are you traveling as part of a group or
organization?
NO
Persons Traveling with You:
Name (1) : AAAA
Relationship to You: Spouse
Name (2) : BBBBB
Relationship to You: Child
Have you ever been in the U.S.? YES (as applicable)
Previous U.S. Visits in the last 5 years:
Travel Date of Arrival (1) : 28 FEBRUARY 2007
Length of Stay: 35 MONTH(S)
Do you or did you hold a U.S. Driver's
License?
YES (as applicable)
Driver's License Number (1) : as applicable
State of Driver's Licence: CALIFORNIA
Have you ever been issued a U.S. Visa? YES
Date Last Visa was Issued: 09 JANUARY 2007
Visa Number: (as applicable on stamped visa page in RED)
Are you applying for the same type of visa? (as applicable)
Are you applying in the same country where
the visa above is issued and is this country
your principal country of residence?
YES
Have you been ten-printed? NO
Has your U.S. Visa ever been lost or stolen? NO
Has your U.S. Visa ever been cancelled or
revoked?
NO (provide correct info as applicable)
Have you ever been refused a U.S. Visa, been
refused admission to the United States, or
withdrawn your application for admission at the
point of entry?
NO (provide correct info as applicable)

U.S. Point of Contact Information section

Contact Person Name in the U.S.: Mention name of your PM or Supervisor in US
Organization Name in the U.S.: your client name
Relationship to You: Business Associate
U.S. Contact Address: As applicable
Phone Number: (Contact persons #)
Email Address: Email of contact person
Family Information section
Father's Surnames: kkkkkk
Father's Given Names: kkkkk
Father's Date of Birth: 04 JANUARY 1946
Is your father in the U.S.? NO
Mother's Surnames: llllllll
Mother's Given Names: ooooo
Mother's Date of Birth: 17 JULY 1950
Is your mother in the U.S.? NO (as applicable)
Do you have any immediate relatives, not
including parents in the U.S.?
NO
Do you have any other relatives in the United
States?
NO
Spouse's Full Name: uuuuu
Spouse's Date of Birth: 10 JUNE 1982
Spouse's Nationality: INDIA
Spouse's City of Birth: JABALPUR
Spouse's Country of Birth: INDIA
Spouses Address: SAME AS HOME ADDRESS (as applicable)
Work / Education / Training Information section
Primary Occupation:
1. For B1, H1, L1 As applicable
2. For dependents , H4/L2 mention as applicable, homemaker/child or as applicable}
Present Employer or School Name: (for dependents mention as applicable)
For Associate: - Genpact LLC
case-1: If in US
Address: 40 Old Ridgebury Road, Danbury, CT, 06810
Case 2: If in India, Current work address in India of Genpact
Month Salary in Local Currency: As applicable (INR) if in India and in dollars, if in US
Briefly Describe your Duties: as applicable
1. For L1/H1 AS applicable
2. For B1 As applicable (pls mention your purpose of travel)
3. For Dependents Joining spouse/parents etc)
Were you previously employed? YES (Provide info as applicable)
Have you attended any educational institutions other than elementary schools?

 YES (Provide relevant info)

Do you belong to a clan or tribe? YES/NO (As applicable)
(provide all the below info as applicable to the applicant)
Have you traveled to any countries within the
last five years?
YES (as applicable)
Country Visited (1) : E.g. DENMARK
Have you belonged to, contributed to, or worked
for any professional, social, or charitable
organization?
NO
Do you have any specialized skills or training,
including firearms, explosives, nuclear, biological,
or chemical experience?
NO
Have you ever served in the military? NO
Have you ever served in, been a member of, or
been involved with a paramilitary unit, vigilante
unit, rebel group, guerrilla group, or insurgent
organization?
NO
Security and Background Information section
Do you have a communicable disease of public NO
health significance such as tuberculosis (TB)?
Do you have a mental or physical disorder that
poses or is likely to pose a threat to the safety or
welfare of yourself or others?
NO
Are you or have you ever been a drug abuser or
addict?
NO
Have you ever been arrested or convicted for any
offense or crime, even though subject of a
pardon, amnesty, or other similar action?
NO
Have you ever violated, or engaged in a
conspiracy to violate, any law relating to
controlled substances?
NO
Are you coming to the United States to engage in
prostitution or unlawful commercialized vice or
have you been engaged in prostitution or
procuring prostitutes within the past 10 years?
NO
Have you ever been involved in, or do you seek to
engage in, money laundering?
NO
Do you seek to engage in espionage, sabotage,
export control violations, or any other illegal

activity while in the United States?

NO
Do you seek to engage in terrorist activities while
in the United States or have you ever engaged in
terrorist activities?
NO
Have you ever or do you intend to provide
financial assistance or other support to terrorists
or terrorist organizations?
NO
Are you a member or representative of a terrorist
organization?
NO
Have you ever ordered, incited, committed,
assisted, or otherwise participated in genocide?
NO
Have you ever committed, ordered, incited,
assisted, or otherwise participated in torture?
NO
Have you committed, ordered, incited, assisted,
or otherwise participated in extrajudicial killings,
political killings, or other acts of violence?
NO
Have you, while serving as a government official,
been responsible for or directly carried out, at any
time, particularly severe violations of religious
freedom?
NO
Have you ever been the subject of a removal or
deportation hearing?
NO
Have you ever sought to obtain or assist others to
obtain a visa, entry into the United States, or any
other United States immigration benefit by fraud
or willful misrepresentation or other unlawful
means?
NO
Have you failed to attend a hearing on
removability or inadmissibility within the last five
years?
NO
Have you ever been unlawfully present,
overstayed the amount of time granted by an
immigration official or otherwise violated the
terms of a U.S. visa?
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?
NO
Have you voted in the United States in violation of
any law or regulation?
NO
Have you ever renounced United States
citizenship for the purpose of avoiding taxation?
NO

Have you attended a public elementary school on

student (F) status or a public secondary school
after November 30, 1996 without reimbursing the
school?
NO
Temporary Work Visa Information section
Where do you intend to work: your client address
Street Address: client address in US
Enter monthly salary (in USD): $6,000 (as applicable)
Do you have an application receipt/petition
number?
YES
Name of Person/Company who Filed Petition: Genpact LLC
Application Receipt/Petition Number: (as applicable)
Location Information
Current Location: As applicable
Preparer of Application:
Did anyone assist you in filling out this
application?
NO
Please Upload the photograph as per the US specification (50x50MM)
Note: Please take at least 2 copies of print outs of the DS-160 confirmation page of self and dependents
(if applicable)