Non-Immigrant Visa - Review Personal, Address, Phone, and Passport... https://ceac.state.gov/GenNIV/General/review/review_reviewpersonal...

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Online Nonimmigrant Visa Application (DS-160) Application ID

Personal, Address, Phone, and Passport Information

Note: You have completed data entry for your NIV application. Before submitting the application, please review your entries
below. To navigate to the next section to be reviewed, click the ‘Next’ button on the bottom of the page. If an entry is incorrect,
click on the links on the right side of the page, which will direct you to the page where you entered the data. Once you have
reviewed all sections, you will be directed to the Sign and Submit page to complete the application process.
Photo Provided: Upload New Photo

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Edit Personal Information

Name Provided:

Full Name in Native Alphabet: DOES NOT APPLY

Other Names Used:

Telecode Name Used:

Sex:

Marital Status:

Date of Birth:

Country/Region of Birth:

Country/Region of Origin (Nationality):

Do you hold or have you held any nationality other than the one
indicated above on nationality?

Are you a permanent resident of a country/region other than your

country/region of origin (nationality) above?

National Identification Number:

U.S. Social Security Number: DOES NOT APPLY

U.S. Taxpayer ID Number: DOES NOT APPLY

Edit Address and Phone Information

Home Address:

City:

State/Province:

Postal Zone/ZIP Code:

Country/Region:

Same Mailing Address?

Primary Phone Number:

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Secondary Phone Number:

Work Phone Number:

Have you used additional phone numbers in the last five years?

Email Address:

Have you used additional email addresses in the last five years?

Do you have a social media presence?

Social Media Provider/Platform (1): Facebook

Social Media Identifier:

Have you used additional social media platforms in the last five years?

Edit Passport/Travel Document Information

Passport/Travel Document Type: REGULAR

Passport/Travel Document Number:

Passport Book Number:

Country/Authority that Issued Passport/Travel Document: NIGERIA

City where issued:

State/Province where issued:

Country/Region where issued: NIGERIA

Issuance Date:

Expiration Date:

Have you ever lost a passport or had one stolen? NO

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Non-Immigrant Visa - Review Travel Information https://ceac.state.gov/GenNIV/General/review/review_reviewtravel.a...

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Online Nonimmigrant Visa Application (DS-160) Application ID AA00

Travel Information

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Edit Travel Information

The List of Purposes of Trip to the U.S.

Purpose of Trip to the U.S. (1): TEMP. BUSINESS PLEASURE VISITOR

(B)

Specify: BUSINESS & TOURISM (TEMPORARY

VISITOR) (B1/B2)

Have you made specific travel plans?

Intended Date of Arrival:

Intended Length of Stay in U.S.:

Address where you will stay in the U.S.:

Person/Entity Paying for Your Trip:

Edit Travel Companions Information

Other Persons Traveling with You:

Edit Previous U.S. Travel Information

Have you ever been in the U.S.?

Have you ever been issued a U.S. Visa?

Date Last Visa was Issued:

Visa Number:

Are you applying for the same type of visa?

Are you applying in the same country or location where the visa above
was issued, and is this country or location your place of principal of
residence?

Have you been ten-printed?

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?

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

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Online Nonimmigrant Visa Application (DS-160) Application ID AA00

U.S. Contact Information

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Edit U.S. Point of Contact Information

Contact Person Name in the U.S.:

Organization Name in the U.S.:

Relationship to You:

U.S. Contact Address:

Phone Number:

Email Address:

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Nonimmigrant Visa - Review Family Information https://ceac.state.gov/GenNIV/General/review/review_reviewFamily....

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Online Nonimmigrant Visa Application (DS-160) Application ID AA00

Family Information

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Edit Family Information: Relatives

Father's Surnames:

Father's Given Names:

Father's Date of Birth:

Is your father in the U.S.?

Mother's Surnames:

Mother's Given Names:

Mother's Date of Birth:

Is your mother in the U.S.?

Do you have any immediate relatives, not including parents in the U.S.?

Do you have any other relatives in the United States?

Edit Family Information: Spouse

Spouse's Full Name:

Spouse's Date of Birth:

Spouse's Country/Region of Origin (Nationality):

Spouse's City of Birth:

Spouse's Country/Region of Birth:

Spouse’s Address:

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Nonimmigrant Visa - Review Work / Education Information https://ceac.state.gov/GenNIV/General/review/review_reviewWorkEd...

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Online Nonimmigrant Visa Application (DS-160) Application ID AA00

Work / Education / Training Information

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Edit Present Work Information

Primary Occupation:

Present Employer or School Name:

Present Employer or School Address:

City:

State/Province:

Postal Zone/Zip Code:

Country/Region:

Start Date:

Work Phone Number:

Monthly Salary in Local Currency (if employed):

Briefly Describe your Duties:

Edit Previous Work Information

Were you previously employed?

Have you attended any educational institutions at a secondary level

or above?

Name of Institution (1):

Address of Institution:

City:

State/Province:

Postal Zone/ZIP Code:

Country/Region:

Course of Study:

Date of Attendance From:

Date of Attendance To:

Edit Additional Information

Do you belong to a clan or tribe? YES

Clan or Tribe Name: YORUBA

Provide a List of Languages You Speak:

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Language Name (1): ENGLISH AND YORUBA

Have you traveled to any countries/regions within the last five

years?

Provide a List of Countries/Regions Visited

Country/Region(1):

Country/Region(2):

Country/Region(3):

Country/Region(4):

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?

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?

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Nonimmigrant Visa - Review Security Information https://ceac.state.gov/GenNIV/General/review/review_reviewsecurity...

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Online Nonimmigrant Visa Application (DS-160) Application ID AA00

Security and Background Information

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Edit Part 1

Do you have a communicable disease of public health significance? (Communicable diseases NO

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 NO
or welfare of yourself or others?

Are you or have you ever been a drug abuser or addict? NO

Edit Part 2

Have you ever been arrested or convicted for any offense or crime, even though subject of a NO
pardon, amnesty, or other similar action?

Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled NO
substances?

Are you coming to the United States to engage in prostitution or unlawful commercialized vice NO
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? NO

Have you ever committed or conspired to commit a human trafficking offense in the United NO
States or outside the United States?

Are you the spouse, son, or daughter of an individual who has committed or conspired to NO
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?

Have you knowingly aided, abetted, assisted or colluded with an individual who has committed NO
or conspired to commit a severe human trafficking offense in the United States or outside the
United States?

Edit Part 3

Do you seek to engage in espionage, sabotage, export control violations, or any other illegal NO
activity while in the United States?

Do you seek to engage in terrorist activities while in the United States or have you ever NO
engaged in terrorist activities?

Have you ever or do you intend to provide financial assistance or other support to terrorists or NO
terrorist organizations?

Are you a member or representative of a terrorist organization? NO

Are you the spouse, son, or daughter of an individual who has engaged in terrorist activity, NO
including providing financial assistance or other support to terrorists or terrorist organizations,
in the last five years?

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 NO

killings, political killings, or other acts of violence?

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Have you ever engaged in the recruitment or the use of the child soldiers? NO

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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 directly involved in the establishment or enforcement of the 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?
NO
Have you ever been directly involved in the coercive transplantation of human organs or
bodily tissue?
Edit Part 4

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, NO
or any other United States immigration benefit by fraud or willful misrepresentation or other
unlawful means?

Have you failed to attend a hearing on removability or inadmissibility within the last five NO
years?

Have you ever been unlawfully present, overstayed the amount of time granted by an NO
immigration official or otherwise violated the terms of a U.S. visa?

Have you ever been removed or deported from any country? NO

Edit Part 5

Have you ever withheld custody of a U.S. citizen child outside the United States from a person NO
granted legal custody by a U.S. court?

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 NO
school after November 30, 1996 without reimbursing the school?

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Online Nonimmigrant Visa Application (DS-160) Application ID AA00

Location Information

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Edit Location Information

Location where you will be submitting your application

Current Location: ABUJA, NIGERIA

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