USA VISA DS-160

U S A VISA DS-160
Sr
Question
# DS 160 Number
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.
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* Interview Language
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1 Surname
:
2 Given Name
Have you ever used other names
(i.e., maiden, religious, professional, alias,
3 etc.)?
Do you have a telecode
4 that represents your name?
:
5 Marital Status
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6 Date and Place of Birth
:
7 Country/Region of Origin (Nationality)
:
Do you hold or have you held
any nationality other than the one
8 indicated above on nationality
:
9 National Identification Number
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L'entretien se fait forcément en anglais, mais vous pouvez demander un interprète.
:
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10 U.S. Social Security Number
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11 U.S. Taxpayer ID Number
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12 Home Address
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13 Mailing Address
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14 Primary Phone Number
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15 Secondary Phone Number
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16 Work Phone Number
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17 Email Address
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ne s'applique pas aux Français
Ici, votre numéro de sécu
l'adresse à laquelle vous voulez recevoir votre visa, mais on vous la demandera
à nouveau sur le site du consulat
18 Passport/Travel Document Number
:
19 Passport Book Number
:
Country/Authority
that Issued Passport/
20 Travel Document
:
Where was the Passport/
Travel Document Issued?
21 City, State, Country
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22 Passport Issuance Date
:
23 Passport Expiration Date
Have you ever lost a passport
24 or had one stolen? If Yes Please Explain
:
25 Purpose of Trip to the U.S.
Have you made specific travel plans?
26 If Yes Fill All Details That Given Below
:
27 Date of Arrival in U.S
:
ne s'applique pas aux Français
:
:
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
encore une fois, vous n'êtes pas censés le savoir
28 Arrival Flight
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29 Arrival City
:
30 Intended Date of Arrival
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31 Intended Length of Stay in U.S.
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32 Date of Departure from U.S
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33 Departure Flight
:
34 Departure City
Provide all locations
35 you plan to visit in the U.S
36 Address Where You Will Stay in the U.S.
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37 Person/Entity Paying for Your Trip
:
Are there other persons traveling with you?
Enter person(s) traveling with you &
38 also enter relationship with person
:
:
:
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
Are you traveling as part of a group
or organization?
Enter the name of the group
39 you are traveling with
Have you ever been in the U.S.?
If Yes Date of Arrived in usa,
40 Length of Stay
41
42
43
44
45
46
47
48
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.
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
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?
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...
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49 Contact Person in the United States
:
50 Organization in the United States
:
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
51 Relationship to You
Address and Phone Number or
52 E mail ID of Point of Contact
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53 Father's Full Name
:
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.?
:
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
59 / Nonimmigrant / Other
Do you have any other relatives
60 in the United States?
:
si si... ils véifient tout...
:
:
61 Spouse's Surnames
:
62 Spouse's Given Names
:
63 Spouse's Date of Birth
Spouse's Country/
64 Region of Origin (Nationality)
65 Spouse's Place of Birth, City & Country
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66 Spouse's Address
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67 Your Primary Occupation
:
68 Present employer or school address:
69 Present employer or school address:
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:
Monthly Income in Local Currency
70 (if employed)
:
71 Briefly describe your duties:
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vraiment, faites bref, ils ont déjà la description complète de votre poste
Were you previously employed?
If Yes
mention Employer Name & Full Address
Job Title
Supervisor's Full Name
Employment Date From & To
72 Briefly describe your duties:
:
Have you attended any educational
institutions at a secondary level or above?
If yes
Name Of Institution
Full Address OF Institution
73 Date of Attendance From & To
:
Do you belong to a clan or tribe?
If Yes
74 Clan or Tribe Name
75 Provide a List of Languages You Speak
:
:
Have you traveled to any countries
within the last five years?
76 If Yes Please Mention All
:
Have you belonged to, contributed to,
or worked for any professional, social,
or charitable organization?
77 If Yes Please Mention All
:
Do you have any specialized skills or
training, such as firearms,
explosives, nuclear, biological, or
chemical experience?
78 If Yes Please Mention All
:
Have you ever served in the military?
If Yes
Country, Branch of Service, Rank/Position,
Military Specialty,
79 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.
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?
80 If Yes Please Mention All
:
A partir de là, en théorie vous allez répondre NON jusqu'à la fin.
Mais lisez quand même, on ne sait jamais
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.)
81 If Yes Please Mention All
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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?
82 If Yes Please Mention All
:
Are you or have you ever been
a drug abuser or addict?
83 If Yes Please Mention All
:
Have you ever been arrested or convicted
for any offense or crime, even though
subject of a pardon, amnesty,
or other similar action?
84 If Yes Please Mention All
:
Have you ever violated, or engaged
in a conspiracy to violate, any law relating
to controlled substances?
85 If Yes Please Mention All
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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?
86 If Yes Please Mention All
Have you ever been involved in,
or do you seek to engage in, money
laundering?
87 If Yes Please Mention All
Have you ever committed or conspired
to commit a human trafficking offense
in the United States or outside the United
States?
88 If Yes Please Mention All
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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?
89 If Yes Please Mention All
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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?
90 If Yes Please Mention All
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Do you seek to engage in espionage,
sabotage, export control violations,
or any other illegal activity while
in the United States?
91 If Yes Please Mention All
Do you seek to engage in terrorist
activities while in the United States
or have you ever engaged in terrorist
activities?
92 If Yes Please Mention All
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:
Have you ever or do you intend to provide
financial assistance or other support to
terrorists or terrorist organizations?
93 If Yes Please Mention All
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Are you a member or representative
of a terrorist organization?
94 If Yes Please Mention All
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Have you ever ordered, incited,
committed, assisted, or otherwise
participated in genocide?
95 If Yes Please Mention All
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Have you ever committed, ordered,
incited, assisted,
or otherwise participated in torture?
96 If Yes Please Mention All
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Have you committed, ordered, incited,
assisted, or otherwise participated in
extrajudicial killings, political killings,
or other acts of violence?
97 If Yes Please Mention All
: NO
Have you ever engaged in the recruitment
or the use of child soldiers?
98 If Yes Please Mention All
: 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?
99 If Yes Please Mention All
: NO
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?
100 If Yes Please Mention All
: NO
Have you ever been directly
involved in the
coercive transplantation of
human organs or bodily tissue?
101 If Yes Please Mention All
: 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?
102 If Yes Please Mention All
: 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?
103 If Yes Please Mention All
: NO
Have you voted in the United States
in violation of any law or regulation?
104 If Yes Please Mention All
: NO
Have you ever renounced United States
citizenship for the purposes
of avoiding taxation?
105 If Yes Please Mention All
: NO