OMB APPROVAL NO 1405-0018

U.S. Department of State EXPIRATION DATE XX/XX/20XX

ESTIMATED BURDEN: 90 MINUTES
CONSOLIDATED NONIMMIGRANT VISA APPLICATION
PLEASE TYPE OR PRINT YOUR ANSWERS IN THE SPACE PROVIDED BELOW EACH ITEM

PASSPORT INFORMATION
Surname (as on passport) First and Middle Names (as on passport)

Passport Travel Document Passport Number Place of Issuance - City Place of Issuance - Country Place of Issuance
Type State/Province

Issuing Country Issuance Date (mm-dd-yyyy) Expiration Date (mm-dd-yyyy)

Have you ever lost a passport or had one stolen? If Yes, Please Provide Passport/Travel Document Country/Authority that Issued Passport/Travel
Number Document
Yes No

Explain

BIOGRAPHICAL INFORMATION
Other Surnames Used (Maiden, Religious, Professional, Aliases)

Other First and Middle Names Used

Full Name in Native Alphabet

Place of Birth Date of Birth (mm-dd-yyyy) Sex

Male Female
City State/Province Country

Nationality National Identification Number (if applicable) Country/Region of Origin (nationality)

Do you hold or have you held any nationality other than the one indicated above on nationality? Yes No
If Yes, Please Provide Name of Country/Region If you hold a passport for the other country/region of origin/nationality,
please enter passport number.

Are you a permanent resident of a country/region other than your country or origin/region (nationality) form above? Yes No
If yes, please enter the Other Permanent Resident Country/Region.

ADDRESS INFORMATION
Apartment Number Street City

Please provide the following

information regarding your home
State/Province Postal Zone Country
address.

Is your mailing address your home address? If no, please provide the following information.
Apartment Number Street City

Please provide the following

information. State/Province Postal Zone Country

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03-2018
PHONE INFORMATION AND EMAIL
Primary Phone Number Secondary Phone Number Work Number Mobile/Cell Number

Have you used any other telephone numbers during the last five years? (If "Yes", list additional telephone numbers used in the space below.)

Yes No

Email Address

Have you used any other email addresses during the last five years? (If "Yes", list additional email addresses used in the space below.)

Yes No

SOCIAL MEDIA
Have you used any of the following social media platforms during the last five years? (If "Yes", provide social media identifier for platform.)

Platform Answer Social Media Identifier(s)

Ask.fm Yes No

Douban Yes No

Facebook Yes No

Flickr Yes No

Google+ Yes No

Instagram Yes No

LinkedIn Yes No

Myspace Yes No

Pinterest Yes No

Qzone (QQ) Yes No

Reddit Yes No

Sina Weibo Yes No

Tencent Weibo Yes No

Tumbler Yes No

Twitter Yes No

Twoo Yes No

Vine Yes No

Vkontakte Yes No

Youku Yes No

YouTube Yes No

None of the Above Yes No

SOCIAL MEDIA - Optional

If you would like to provide information about your presence on any other websites or applications you have used within the last five years to create or
share content (photos, videos, status updates, etc.), please list the platform and associated unique social media identifier (username or handle) below.

Platform Social Media Identifier(s)

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TRAVEL INFORMATION (Please provide the following information concerning your travel plans.)
Purpose of the Trip to the United States Specify Person/Entity Paying for Your Trip

Surname of Person Paying for Your Trip Given Names of Person Paying for Your Trip Telephone of Person Paying for Your Trip

Email Address of Person Paying for Your Trip Relationship to You Intended Length of Stay in the U.S.

Intended Date of Arrival (mm-dd-yyyy)

Is the address of the party paying for your trip the same as your mailing address? Yes No
If no, please provide street address, city, state/province, postal zone/ZIP code, country/region.
Intended Arrival Flight Number (if known)

Intended Date of Departure (mm-dd-yyyy) Departure Flight Number (if known) Departure City

Please Provide Street Address of Where You City/State Zip Code

Intend to Stay

Are there persons traveling with you? If yes, please provide the surname and given Relationship with the Person
name of person traveling with you.
Yes No

Are you traveling as part of a group or If yes, please provide the name of the group you are traveling with.
organization?
Yes No

PURPOSE OF TRIP TO UNITED STATES

If your purpose of travel is to come as a Student/Exchange Visitor (F1, F3, J1, M1, M3) please provide additional Point of Conact 1, additional Point of
Contact 2 and Sevis information.
Additional Point of Contact 1
Surname Given Name

Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country/Region

Telephone Number Email Address

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Additional Point of Contact 2
Surname Given Name

Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country/Region

Telephone Number Email Address

SEVIS INFORMATION
SEVIS ID Principal Applicant SEVIS ID (if applicable)

Program Number (J1) Do you intend to Study in the U.S.? Yes No If yes, explain

Name of School Course of Study

Street Address (line 1) Street Address (line 2)

City State Postal Zone/Zip Code

If Your Purpose of Travel is to Come as a CREW MEMBER IN TRANSIT (C1/D) OR CREWMEMBER (D), Please Provide the Following Information
Specific Job Title Aboard Aircraft of Vessel

Company Telephone Number Name of Company that Owns the Aircraft or Vessel you will be Working on

Did you acquire your position using a recruiting/manning/crewing agency? Yes No If yes, please provide the following:

Agency Name Contact Surname Contact Given Name

Street Address (line 1) Street Address (line 2)

City State Postal Zone/Zip Code

Country/Region Telephone Number

Did you acquire your position using a recruiting/manning/crewing agency? Yes If yes, please provide the following:

Seagoing Ship/Vessel Name Seagoing Ship/Vessel Identification Number

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Please fill out one of the following boxes depending on your Temporary Work Visa Class.

Temporary Work Visa information for A1, A2, (A3), E3, E3R, G5, H1B1, l, NATO1-NATO6 (NATO7), Q, TN Visa Applicants
Name of Employer Monthly Income

U.S. Street Address (line 1) U.S. Street Address (line 2)

City State Country Region

Zip Code Phone Number

OR..

Temporary Work Visa Information for CW1, E2C, H1B, H1C, H2A, H2B, H3, L1, O1, O2, P1, P2, P3, R1 Visa Applicants
Application Receipt/Petition Number Name of Person/Company who Filed Petition

Name of Employer Monthly Income

U.S. Street Address (line 1) U. S. Street Address (line 2)

City State Phone Number

Zip Code Phone Number

OR..

Temporary Work Visa Information for E1or E2 Visa Applicants

Name of Employer E Visa Company Registration Number

U.S. Street Address (line 1) U. S. Street Address (line 2)

City State Phone Number

PREVIOUS U.S. TRAVEL INFORMATION

(Please provide the following previous U.S. travel information. Provide complete and accurate information to all questions that require an explanation.)
Did you acquire your position using a recruiting/manning/crewing agency? Yes No
If yes, please provide information on your last five U.S. visits.
Date of Arrival 1. 2. 3. 4. 5.
(mm-dd-yyyy)

Length of "Stay
If you have ever visited the U.S. please answer the following questions.
Have you ever been the subject of a removal or deportation hearing? Yes No If yes, explain

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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 any other unlawful means?
Yes No If yes, explain.

Have you ever been unlawfully present in the U.S. for more than one year in the aggregate at any time during the past ten years?
Yes No If yes, explain.

Have you failed to attend a hearing on removability or or inadmissibility within the last five years?
Yes No If yes, explain.

Have you ever been unlawfully present, or overstayed the amount of time granted by an immigration official or otherwise violated the terms of a U.S.
Visa?
Yes No If yes, explain.

Have you ever been issued a U.S. Visa? Do you or did you ever hold a U.S. Driver's License?
Yes No If yes, please provide the following information Yes No If yes, please provide the following information.

Date last Visa was

State License Issued
Issued (mm-dd-yyyy)

Visa Number License Number

If you were issued a U.S. Visa previously, are you applying for the same Visa? Yes No
If you were issued a U.S. Visa previously, please provide the following information

a. Are you applying in the same country where the U.S. Visa above was issued? Yes No

b. Is this country your principal country of residence? Yes No

c. Have you ever been ten-printed? Yes No

d. Has your U.S. Visa ever been stolen? Yes No If yes, please provide year Visa was stolen.

e. Has your U.S. Visa ever been cancelled or revoked?

Yes No If yes, please explain.

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 f. Have you ever been removed or deported from any country?
Yes No If yes, please explain.

h. Have you ever been refused a U.S. Visa? Yes No If yes, please explain.

i. Have you ever been refused admission to the United States? Yes No If yes, please explain.

j. Have you ever had your application for admission at the port of entry withdrawn? Yes No If yes, please explain.

k. Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and immigration Services?

Yes No If yes, please explain.

l. Have you ever been denied travel authorization by the Department of Homeland Security through the Electronic System for Travel Authorization?

Yes No If yes, please explain.

m. Have you ever been a U.S. legal permanent resident? Yes No If yes, please explain.

U.S. POINT OF CONTACT

Your U.S. Point of Contact can be any individual in the U.S. who knows you and can verify, if necessary, your identity. If you do not personally know
anyone in the U.S., you may enter the name of the store, company or organization you plan to visit during your trip.
Contact Person (skip if you do not know) Surnames Given Names

Organization (skip if you do not know) Organization Name Relationship to you

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U.S. ADDRESS AND PHONE NUMBER OF POINT OF CONTACT
Street Address (line 1) Street Address (line 2)

City State Zip Code

Phone Number Email Address

FAMILY INFORMATION
Please provide the following information concerning your biological parents. If adopted, please provide the following information on your adoptive
parents.
Father's Full Name and Date of Birth
Surname Given Names Date of Birth (mm-dd-yyyy) Year of Death

Is your father in the United Street Address (line 1) City Zip Code
States? Yes No
Father's Status Street Address (line 2) State/Province Country

Mother's Full Name and Date of Birth

Surname Given Names Date of Birth (mm-dd-yyyy) Year of Death

Is your mother in the United Street Address (line 1) City Zip Code
States? Yes No
Mother's Status Street Address (line 2) State/Province Country

Do you have any immediate relatives, not including parents, in the United States? Yes No If yes please provide the following information below.
(Immediate relatives means fiancé/fiancée, spouse (husband/wife), child (son/daughter), or sibling (brother/sister)).
Surname Given Names Relationship to You Relatives Status

Do you have any immediate relatives, not including parents, in the United States? Yes No If yes please provide the following information below

Surname Given Names Relationship to You Relatives Status

Do you have any immediate relatives, not including parents, in the United States? Yes No If yes please provide the following information below

Surname Given Names Relationship to You Relatives Status

FAMILY INFORMATION - SPOUSE

Do you have any former spouses? Yes No If yes, please provide former spouse information below

Surnames Given Names Date of Birth (mm-dd-yyyy) City of Birth

Country/Region of Origin (nationality) Number of Former Spouses Date of Marriage (mm-dd-yyyy)

County/Region Country/Region Marriage was Terminated Date Marriage Ended (mm-dd-yyyy)

Explain how the marriage ended

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FIANCE/FIANCEE INFORMATION (If you are K-1 or K-3 applicant, please provide the following information)
Fiancé/Fiancée Full Name and Date of Birth
Surname Given Names Date of Birth (mm-dd-yyyy) Occupation

Street Address (line 1) City Zip Code

Apt # (line 2) State/Province Country

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FAMILY INFORMATION - CHILDREN Please provide the following information if you are a k1, k3 applicant.
Do you have any children? Yes No If yes please provide information below

Birth Date Will accompany you? Will follow you?

Surname Given Name Birth Place
(mm-dd-yyyy)

Yes No Yes No

Yes No Yes No

Yes No Yes No

Yes No Yes No

Yes No Yes No

PRESENT WORK/EDUCATION/TRAINING INFORMATION

Provide the following information concerning your current employment or education.
Primary Occupation Profession Present Employer or School Name

Address of Employee or School

Street Address (line 1) Street Address (line 2)

City State/Province Phone Number

Postal Zone/Zip Code Monthly Income Country Region

Briefly Describe Your Duties

Education Degrees, Licenses, or Alternative Credentials for Your Profession

PREVIOUS WORK/EDUCATION/TRAINING INFORMATION

Provide your employment information for the last five years that you were employed, if applicable. Do not list your current employment listed elsewhere
in this application.

Were you previously employed? Yes No If yes please provide the following information below
Employer Name
Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country Region

Telephone Number Job Title

Supervisor's Surname Supervisor's Given Name

Employment Date From (mm-dd-yyyy) Employment Date To (mm-dd-yyyy)

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Employer Name
Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country Region

Telephone Number Job Title

Supervisor's Surname Supervisor's Given Name

Employment Date From (mm-dd-yyyy) Employment Date To (mm-dd-yyyy)

Briefly Describe Your Duties

Employer Name
Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country Region

Telephone Number Job Title

Supervisor's Surname Supervisor's Given Name

Employment Date From (mm-dd-yyyy) Employment Date To (mm-dd-yyyy)

Briefly Describe Your Duties

Employer Name
Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country Region

Telephone Number Job Title

Supervisor's Surname Supervisor's Given Name

Employment Date From (mm-dd-yyyy) Employment Date To (mm-dd-yyyy)

Briefly Describe Your Duties

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PREVIOUS WORK/EDUCATION/TRAINING INFORMATION - continued
Briefly Describe Your Duties

Employer Name
Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country Region

Telephone Number Job Title

Supervisor's Surname Supervisor's Given Name

Employment Date From (mm-dd-yyyy) Employment Date To (mm-dd-yyyy)

Briefly Describe Your Duties

Employer Name
Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country Region

Telephone Number Job Title

Supervisor's Surname Supervisor's Given Name

Employment Date From (mm-dd-yyyy) Employment Date To (mm-dd-yyyy)

Briefly Describe Your Duties

Have you attended any educational institutions at a secondary level or above? Yes No If yes please provide the following information
below
Name of Institution Choice of Study

Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country Region

Date of Attendance From (mm-dd-yyyy) Date of Attendance to (mm-dd-yyyy)

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 If yes please provide the following information
Have you attended any educational institutions at a secondary level or above? Yes No
below.
Name of Institution Choice of Study

Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country Region

Date of Attendance From (mm-dd-yyyy) Date of Attendance to (mm-dd-yyyy)

Name of Institution Choice of Study

Street Address (line 1) Street Address (line 2)

City State/Province

Postal Zone/Zip Code Country Region

Date of Attendance From (mm-dd-yyyy) Date of Attendance to (mm-dd-yyyy)

ADDITIONAL INFORMATION
Do you belong to a clan or tribe? If yes please provide the following information below.
Yes No
Provide the languages you speak below. Provide the countries you have traveled in the last five years below.

Have you belonged to, contributed to, or worked for any professional, social, or charitable organizations? Yes No
If yes please provide the names of organizations below.
Organization Names

Do you have any specialized skills or training, such as firearms, explosives, nuclear, biological, or chemical experiences? Yes No
Explain

Have you ever served in the military? If yes please provide the following information below.
Yes No
Country/Region Branch of Service

Rank/Position Military Specialty

Date of Service From (mm-dd-yyyy) Date of Service to (mm-dd-yyyy)

Have you ever served in, been a member of, or been involved with a paramilitary unit, rebel group, guerilla group, or insurgent organization?
Yes No If yes explain below.

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Please provide the following security and background information. Provide complete and accurate information to all questions that require
an explanation. 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). Are any of the following applicable to you? While a YES answer does not automatically
ineligibility for a visa, if you answer YES you may be required to personally appear before a consular officer.

Do you have a communicable disease of public health significance? (Communicable diseases of public significance include cancroid, gonorrhea,
granuloma, inguinale, infectious leprosy, lymphogranuloma venereum, infectious stage syphilis, active tuberculosis, and other diseases as determined
by the Department of Health and Human Services.)

Yes No If yes explain below.

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?

Yes No If yes explain below.

Are you or have you ever been a drug abuser or addict?

Yes No If yes explain below.

Do you have documentation to establish that you have received vaccinations in accordance with U.S law?

Yes No If yes explain below.

Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty, or other similar offense?

Yes No If yes explain below.

Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substance?

Yes No If yes explain below.

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?

Yes No If yes explain below.

Have you ever been involved in, or do you seek to engage in, money laundering?

Yes No If yes explain below.

Have you ever committed or conspired to commit a human trafficking offense in the United States or outside the United States?

Yes No If yes explain below.

Have you ever knowingly aided, abetted, assisted or colluded with an individual who has committed, or conspired to commit a severe human trafficking
offense in the United States or outside the United States?
Yes No If yes explain below.

Are you the spouse, son, or daughter of an individual who has committed or conspired to commit a human trafficking offense in the United States or
outside the United States and have you within the last five years, knowingly benefited from the trafficking activities?

Yes No If yes explain below.

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Are you the spouse, son, or daughter of an individual who has been identified by the President of the United States as a person who plays a significant
role in a severe form of trafficking in persons and have you, with the the last five years, knowingly benefited from the trafficking activities?
Yes No If yes explain below.

Are you the spouse, son or daughter of an individual who has violated any controlled substance trafficking law, and has knowingly benefited from the
trafficking in the past five years?
Yes No If yes explain below.

Do you seek to engage in espionage, sabotage, export control violations or any other illegal activity in the United States?
Yes No If yes explain below.

Have you or do you intend to provide financial assistance or other support to terrorist or terrorist organizations?
Yes No If yes explain below.

Are you a member or representative of a terrorist organization?

Yes No If yes explain below.

Are you the spouse, son, or daughter of an individual who has engaged in terrorist activity, including providing financial assistance or other support to
terrorists or terrorist organizations, in the last five years?
Yes No If yes explain below.

Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide?
Yes No If yes explain below.

Have you ever been directly involved in the coercive transplantation of human organs or bodily tissue?
Yes No If yes explain below.

Have you ever committed, or tortured, incited, assisted, or otherwise participated in torture?
Yes No If yes explain below.

Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings, political killings, or other acts of violence?
Yes No If yes explain below.

Have you ever engaged in the recruitment or the use of child soldiers?
Yes No If yes explain below.

Have you, while serving as a government official, been responsible for or directly carried out, at any time, particularly severe violations of religious
freedom?
Yes No If yes explain below.

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Have you ever been directly involved in the establishment or enforcement of population controls forcing a woman to undergo an abortion against her
free choice or a man or a woman to undergo sterilization against his or her free will?
Yes No If yes explain below.

Have you been ordered removed from the U.S. during the last five years?
Yes No If yes explain below.

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?
Yes No If yes explain below.

Are you subject to a civil penalty under INA 274C?

Yes No If yes explain below.

Have you been ordered removed from the U.S. for a second time within the last 20 years?
Yes No If yes explain below.

Have you ever been convicted of an aggravated felony and been order removed from the U.S.?
Yes No If yes explain below.

Have you ever been unlawfully present in the U.S. for more than 180 days (but no more than one year) and have voluntarily departed the U.S. within
the last three years?
Yes No If yes explain below.

Have you ever been unlawfully present in the U.S. for more than one year in the aggregate at any time during the past ten years?
Yes No If yes explain below.

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?
Yes No If yes explain below.

Have you ever voted in the United States in violation of any law or regulation?
Yes No If yes explain below.

Have you ever renounced United States citizenship for the purposes of avoiding taxation?

Yes No If yes explain below.

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Have you attended a public elementary school on student (F) status or a public secondary school after November 30, 1996 without reimbursing the
school?
Yes No If yes explain below.

Are you a former exchange visitor who has not yet fulfilled the two year foreign residence requirement?
Yes No If yes explain below.

Do you seek to enter the United States for purpose of performing skilled or unskilled labor but have not yet been certified by the Secretary of Labor?
Yes No If yes explain below.

Are you a graduate of a foreign medical school seeking to perform medical services in the United States but have not yet passed the National Board of
Medical Examiners examination or its equivalent?
Yes No If yes explain below.

Are you a healthcare worker seeking to perform such work in the United States but have not yet received certification from the Commission on
Graduates of Foreign Nursing Schools or from an equivalent approved independent credentialing organization?
Yes No If yes explain below.

Are you permanently ineligible for U.S. citizenship?

Yes No If yes explain below.

Have you ever departed the United States in order to evade military service during a time of war?
Yes No If yes explain below.

Are you coming to the U.S. to practice polygamy?

Yes No If yes explain below.

Has an immigration judge or the Board of Immigration Appeals ever determined that you had knowingly made a frivolous application for asylum?
Yes No If yes explain below.

Are you a member of or affiliated with the Communist or other totalitarian party?
Yes No If yes explain below.

Have you ever directly or indirectly assisted or supported any of the groups in Colombia known as the Revolutionary Armed Forces of Colombia
(FARC), National Liberation Army (ELN), or United Self-Defense Forces of Colombia (AUC)?
Yes No If yes explain below.

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Have you ever through abuse of governmental or political position converted for personal gain, confiscated or expropriated property in a foreign nation
to which a United States national had claim of ownership?
Yes No If yes explain below.

Are you the spouse, minor child, or agent of an individual who has through abuse of governmental or political position converted for personal gain,
confiscated, or expropriated property in a foreign nation to which a United States national had claim of ownership?

Yes No If yes explain below.

Have you ever disclosed or trafficked in confidential U.S. business information obtained in connection with U.S. participation in the Chemical Weapons
Convention?
Yes No If yes explain below.

Are you the spouse, minor child, or agent of an individual who has disclosed or trafficked in confidential U.S. business information obtained in
connection with U.S. participation in the Chemical Weapons Convention?
Yes No If yes explain below.

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 PLEASE READ THE INFORMATION CAREFULLY BEFORE SIGNING AND SUBMITTING YOUR APPLICATION

The information that you have provided in your application and other information submitted with you application may be accessible to other government
agencies having statutory or other lawful authority to use such information, including for law enforcement and immigration law enforcement purposes.
The photograph that you provided with your application may be used for employment verification or other U.S. law purposes.

Applicant's Signature ___________________________________________________

I understand that I am required to submit my visa to the United States Immigration Officer at the place where I apply to enter the United States, and that
the possession of a visa does not entitle me to enter the United States if at that time I am found inadmissible under the immigration laws.

Applicant's Signature ___________________________________________________

I understand that any willfully false or misleading statement or willful concealment of a material fact made by me herein may subject me to permanent
exclusion from the United States and, if I am admitted to the United States, may subject me to criminal prosecution and or/deportation.

Applicant's Signature ___________________________________________________

Nonimmigrant Fiancé(e) Applicant: I hereby certify that I am legally free to marry and intend to marry
a U.S. Citizen, within 90 days of my admission into the United States.

Applicant's Signature ___________________________________________________

I do solemnly swear or affirm that all statements which appear in this application have been made by me and are true and complete to best of my
knowledge and belief.

Applicant's Signature ___________________________________________________

Was this application prepared by another person on your behalf? If yes please have that person complete provide the information below

Application Prepared by

Relationship to Applicant

Address

Signature of Person Preparing Form ___________________________________________________

Date (mm-dd-yyyy)

Paperwork Reduction Act Statement

Public reporting burden for this collection of information is estimated to average 90 minutes per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: A/GIS/DIR, Room 2400 SA-22, U.S. Department of State, Washington,
DC 20522-2202.

Confidentiality Statement

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.

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