U S A VISA DS-160 Sr Question Answer Le numéro vous sera donné dès le départ. Pour reprendre le formulaire si vous le faites en plusieurs fois, pas besoin de vous souvenir de la question de sécurité, elle vous est donnée. Le mieux, c'est de faire une capture d'écran dès le début. # DS 160 Number : * Interview Language : L'entretien se fait forcément en anglais, mais vous pouvez demander un interprète. 1 Surname : 2 Given Name : 3 Have you ever used other names (i.e., maiden, religious, professional, alias, etc.)? : 4 Do you have a telecode that represents your name? : ne s'applique pas aux Français 5 Marital Status : 6 Date and Place of Birth : 7 Country/Region of Origin (Nationality) : 8 Do you hold or have you held any nationality other than the one indicated above on nationality : 9 National Identification Number : Ici, votre numéro de sécu 10 U.S. Social Security Number : 11 U.S. Taxpayer ID Number : 12 Home Address : 13 Mailing Address : l'adresse à laquelle vous voulez recevoir votre visa, mais on vous la demandera à nouveau sur le site du consulat 14 Primary Phone Number : 15 Secondary Phone Number : 16 Work Phone Number : 17 Email Address :
18 Passport/Travel Document Number : 19 Passport Book Number : 20 21 Country/Authority that Issued Passport/ Travel Document : Where was the Passport/ Travel Document Issued? City, State, Country : ne s'applique pas aux Français 22 Passport Issuance Date : 23 Passport Expiration Date : 24 Have you ever lost a passport or had one stolen? If Yes Please Explain : 25 Purpose of Trip to the U.S. : 26 Have you made specific travel plans? If Yes Fill All Details That Given Below : et c'est là qu'on voit à quel point ils ne sont pas logiques, puisqu'ils vous conseillent de ne pas prendre vos billets d'avion et de ne rien prévoir tant que vous n'avez pas votre visa... Donc dites NON 27 Date of Arrival in U.S : 28 Arrival Flight : encore une fois, vous n'êtes pas censés le savoir 29 Arrival City : 30 Intended Date of Arrival : 31 Intended Length of Stay in U.S. : 32 Date of Departure from U.S : 33 Departure Flight : 34 Departure City : 35 Provide all locations you plan to visit in the U.S : 36 Address Where You Will Stay in the U.S. : Si vous restez 5 ans, on ne vous demande pas de planifier vos vacances, par contre si c'est pour quelques mois, vous devez avoir une petite idée. Pas besoin d'être bien précis à mon avis. La première adresse à laquelle vous serez, même un hôtel pour une semaine 37 Person/Entity Paying for Your Trip : 38 Are there other persons traveling with you? Enter person(s) traveling with you & also enter relationship with person :
39 40 41 42 Are you traveling as part of a group or organization? Enter the name of the group you are traveling with : Have you ever been in the U.S.? If Yes Date of Arrived in usa, Length of Stay : Do you or did you ever hold a U.S. Driver s License? If Yes Please Provide Driving Licence No & State of Driver's License : Have you ever been refused a U.S. Visa, or been refused admission to the United States, or withdrawn your application for admission at the port of entry? If yes Explain About It. : 43 Have you ever been issued a U.S. Visa? If Yes Please Give Details : Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and Immigration Services? If Yes Please Provide Full Deails 44 Have you been ten-printed? : 45 46 47 48 Has your U.S. Visa ever been lost or stolen : Has your U.S. Visa ever been cancelled or revoked? : Have you ever been refused a U.S. Visa, or been refused admission to the United States, or withdrawn your application for admission at the port of entry? If yes please Explain : Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and Immigration Services? If yes Explain : Ne vous trompez pas, ils le savent déjà... est-ce qu'on a déjà pris vos empreintes complètes. En théorie non, en tout cas on ne prend pas les 10 pour un passeport biométrique 49 Contact Person in the United States : 50 Organization in the United States :
51 Relationship to You : 52 Address and Phone Number or E mail ID of Point of Contact : 53 Father's Full Name : si si... ils véifient tout... 54 Father's Date of Birth : 55 Is your father in the U.S.? : 56 Mother's Full Name : 57 Mother's Date of Birth : 58 Is your Mother in the U.S.? : 59 60 Do you have any immediate relatives, not including parents, in the United States? If yes Please Give Details Mentione Below. Full Name, Relationship to You, Relative's Status In USA (US Citizen / US Legal Permanent Resident / Nonimmigrant / Other : Do you have any other relatives in the United States? : 61 Spouse's Surnames : 62 Spouse's Given Names : 63 Spouse's Date of Birth : 64 Spouse's Country/ Region of Origin (Nationality) : 65 Spouse's Place of Birth, City & Country : 66 Spouse's Address : 67 Your Primary Occupation : 68 Present employer or school address: : 69 Present employer or school address: : 70 Monthly Income in Local Currency (if employed) : 71 Briefly describe your duties: : vraiment, faites bref, ils ont déjà la description complète de votre poste
72 Were you previously employed? If Yes mention Employer Name & Full Address Job Title Supervisor's Full Name Employment Date From & To Briefly describe your duties: : 73 Have you attended any educational institutions at a secondary level or above? If yes Name Of Institution Full Address OF Institution Date of Attendance From & To : 74 Do you belong to a clan or tribe? If Yes Clan or Tribe Name : 75 Provide a List of Languages You Speak : 76 77 78 79 Have you traveled to any countries within the last five years? Have you belonged to, contributed to, or worked for any professional, social, or charitable organization? Do you have any specialized skills or training, such as firearms, explosives, nuclear, biological, or chemical experience? Have you ever served in the military? If Yes Country, Branch of Service, Rank/Position, Military Specialty, Date of Service From & To : Tout est enregistré sur votre passeport, alors ne vous trompez pas, ils pourraient croire que vous leur cacher quelque chose. 80 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? A partir de là, en théorie vous allez répondre NON jusqu'à la fin. Mais lisez quand même, on ne sait jamais
81 82 83 84 85 86 87 88 Do you have a communicable disease of public health significance? (Communicable diseases of public significance include chancroid, 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.) 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? Are you or have you ever been a drug abuser or addict? Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty, or other similar action? Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substances? 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? Have you ever been involved in, or do you seek to engage in, money laundering? Have you ever committed or conspired to commit a human trafficking offense in the United States or outside the United States?
89 90 91 92 93 94 95 96 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? 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? Do you seek to engage in espionage, sabotage, export control violations, or any other illegal activity while in the United States? Do you seek to engage in terrorist activities while in the United States or have you ever engaged in terrorist activities? Have you ever or do you intend to provide financial assistance or other support to terrorists or terrorist organizations? Are you a member or representative of a terrorist organization? Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide? Have you ever committed, ordered, incited, assisted, or otherwise participated in torture?
97 98 99 100 101 102 103 104 Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings, political killings, or other acts of violence? Have you ever engaged in the recruitment or the use of child soldiers? Have you, while serving as a government official, been responsible for or directly carried out, at any time, particularly severe violations of religious freedom? 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? Have you ever been directly involved in the coercive transplantation of human organs or bodily tissue? 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? 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? Have you voted in the United States in violation of any law or regulation?
105 Have you ever renounced United States citizenship for the purposes of avoiding taxation?