Usa Customer Form Fill Up
Usa Customer Form Fill Up
Usa Customer Form Fill Up
12. Who will pay for your trip? Give the Name, Relation, Address & Phone Number.
13. Names and relationships of persons traveling with you. (If Applicable)
14. Have you ever been in the U.S.? When (Date of Arrival), for how long? (Last five U.S. visit)
Arrival date- I I ; Length of stay _ Arrival date- I I ; Length of stay _
Arrival date- I I ; Length of stay _ Arrival date- I I ; Length of stay _
Arrival date- I I ; Length of stay _
• U.S. Drivers license Number and State of Drivers license. (If Applicable)
15. Have you ever been issued a U.S. visa? (If YES give Date last visa was Issued, visa class and
Visa Number (8 digits)
16. Have you ever been Lost/refused/cancelled/revoked a U.S. visa? When? Where? What type of
Visa? (If Applicable)
• Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and Immigration Services?
Explain
*Are you or have you ever been a U.S. leaal permanent resident?
17. Full Name and Address And Relationship of Contact Person or Organization in the U.S. (Include
Zip code, Telephone Number and E-mail)
25. List all educational institutions you attend or have attended (If Applicable).
Give the Name of Institutions, Address, Course of S”tudy and Duration: Start to End (dd/mm/yyyy)
28. List all Professional, Social and Charitable Organizations to which you belong.
30. Have you used any other email addresses in the last five years?
Have you used any other phone numbers in the last five years?