DS260 Form: Required Information –
SECTION I: PERSONAL INFO (OF THE VISA APPLICANT)
1. What is your full last name? (i.e. Fernandez Garcia)
2. What is your given name?
3. What is your full name in your native alphabet? (if different from above)
4. Have you ever used any other names? (i.e. maiden name) Please provide all names used.
5. What is your marital status?
6. What is your date and place of birth? Please include…
a) Date of birth
b) City of birth
c) State/province of birth
d) Country of birth
7. What is your nationality?
8. Provide the following information about your travel documentation…
a) Document type (i.e. passport)
b) Document ID
c) Country/authority that issued the document
d) Issuance date (dd-mm-yyyy)
e) Expiration date (dd-mm-yyyy)
9. Do you hold or have you held a nationality other than the one you have indicated above? (Circle
one.)
a) Yes
b) No  Skip to Q11
10. If you answered “Yes” to Q9, please provide all nationalities you have previously held, regardless
of whether you have formally and/or legally relinquished the nationality. If the country where you
previously held nationality is no longer a political entity or country, provide the nationality that
corresponds with the name of the country that is currently used for that location.
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SECTION II: PRESENT AND PREVIOUS ADDRESS INFORMATION
11. What is your present address? Please provide…
a) Street address, including any apartment number
b) City
c) State
d) ZIP code
e) Country
f) Date on which you began living at this address
12. Have you lived anywhere other than this address since the age of sixteen? (Circle one.)
a) Yes
b) No  Skip to Q14
13. If you answered “Yes” to Q12, please provide the following information for EACH address you
lived at since the age of sixteen. Begin with your address immediately before your current
address.
a) Street address, including any apartment number
b) City
c) State
d) ZIP code
e) County
f) Dates on which you lived at this address - from/to (provide month and year)
14. What is your primary phone number? Please provide a secondary phone number and work phone
number, also, if you have them?
15. What is your E-mail address?
16. Is your mailing address the same as your present address? (Circle one.)
a) Yes  Skip to Q18
b) No
17. If you answered “No” to Q16, please provide your mailing address. Include the following
information…
a) Street address, including any apartment number
b) City
c) State
d) ZIP code
e) Country
18. Do you have an address in the United States where you intend to live? (Circle one.)
a) Yes
b) No  Skip to SECTION III
19. If you answered “Yes” to Q18, please provide the following information
a) Name of person living at this address
b) U.S. Street address, including any apartment number
c) City
d) State
e) ZIP code
f) Phone Number
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20. Is this the address (US address) where you want your permanent resident card mailed? (Circle
one.)
a) Yes  Skip to SECTION III
b) No
21. If you answered “No” to Q20, please provide address where you want resident card sent. Include
the following information…
a) Contact person at this address
b) US Street address, including any apartment number
c) City
d) State
e) ZIP code
f) Phone Number
SECTION III: FAMILY INFORMATION (OF THE VISA APPLICANT)
22. Please provide the following information about your father
a) Full Name (First, last and middle)
b) Date of birth (dd-mm-yyyy)
c) Place of birth
i.
City of birth
ii.
State of birth
iii.
Country of birth
d) Is he still living? (Circle one.)
i.
Yes
ii.
No  Skip to Part (f)
e) If your father is still living, please provide his current address including the following.
Then Skip to Q23.
i.
Street address
ii.
City
iii.
State
iv.
Country
f) If your father is NOT living, please provide his year of death
23. Please provide the following information about your mother
a) Full Name (First, last and middle)
b) Date of birth (dd-mm-yyyy)
c) Place of birth
i.
City of birth
ii.
State of birth
iii.
Country of birth
d) Is she still living? (Circle one.)
i.
Yes
ii.
No  Skip to Part (f)
e) If your mother is still living, please provide her current address including the following.
Then Skip to Q24.
i.
Street address
ii.
City
iii.
State
iv.
Country
f) If your mother is NOT living, please provide her year of death
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24. Please provide the following information about your current spouse
a) Full name (First, last and middle)
b) Date of birth (dd-mm-yyyy)
c) Place of birth
i.
City of birth
ii.
State of birth
iii.
Country of birth
d) His/her present address
e) His/her occupation
f) Date of marriage (dd-mm-yyyy)
g) Place of marriage
i.
City of marriage
ii.
State of marriage
iii.
Country of marriage
h) Is your spouse immigrating to the U.S. with you? (Circle one.)
i.
Yes  Skip to Q25
ii.
No
i) Is your spouse immigrating to the U.S. at a later date to join you? (Circle one.)
i.
Yes
ii.
No
25. Have you been previously married? (Circle one.)
a) Yes
b) No  Skip to Q28
26. If you answered “Yes” to Q25, please indicate the number of times you have been previously
married.
27. Please provide the following information about EACH of your previous spouses.
a) Full name of former spouse
b) Spouses date of birth (dd-mm-yyyy)
c) Date of marriage (dd-mm-yyyy)
d) Date marriage was terminated (dd-mm-yyyy)
e) How was marriage terminated (annulment, death, divorce, other)
f) Country where marriage was terminated
28. Do you have any children? (Circle one.)
a) Yes
b) No  Skip to SECTION IV
29. If you answered “Yes” to Q28, please indicate the number of children you have.
30. Please provide the following information for EACH of your children…
a) Child’s full name
b) Date of birth (dd-mm-yyyy)
c) Place of birth
i.
City of birth
ii.
State of birth
iii.
Country of birth
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d) Does this child live with you? (Circle one.)
i.
Yes  Please provide address where child is living. Include…
1) Street number
2) City
3) State
4) Country
ii.
No
e) Is the child immigrating to the US with you? (Circle one.)
i.
Yes  Skip to Next Child or, if that was the last/only child, skip to SECTION IV
ii.
No
f) Will the child immigrate at a later date? (Circle one.)
i.
Yes
ii.
No
SECTION IV: PREVIOUS TRAVEL TO THE U.S
31. Have you ever been in the US? (Circle one.)
a) Yes
b) No  Skip to Q33
32. If you answered “Yes” to Q31, please provide the following information…
a) Were you ever issued an A-number? If YES, please provide your A-Number
b) Please provide the following information for you last FIVE visits
i.
On what date did you arrive in the U.S.? (dd-mm-yyyy)
ii.
How long did you stay?
33. Have you ever been issued a US Visa? (Circle one.)
a) Yes
b) No  Skip to Q35
34. If you answered “Yes” to Q33, please provide the following information…
a) Date Visa was issued (dd-mm-yyyy)
b) Visa classification
c) Visa number
d) Has your Visa ever been lost or stolen? (Circle one.)
i.
Yes  Provide the year in which the visa was lost or stolen and an explanation.
ii.
No
e) Have any of your visas ever been cancelled or revoked? (Circle one.)
i.
Yes  EXPLAIN
ii.
No
35. Have you ever been refused a Visa, refused admission into the US, or withdrawn your application
for admission? (Circle one.)
a) Yes  EXPLAIN
b) No
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SECTION V: PRESENT WORK/EDUCATION/TRAINING INFORMATION
36. What is your primary occupation?
37. Please provide the following information about your present employer or school
a) Name of employer/school
b) Address of employer/school
i.
Street address, including any suite number
ii.
City
iii.
State
iv.
ZIP code
v.
Country
38. Do you have other occupations? (Circle one.)
a) Yes
b) No  Skip to Q40
39. If you answered “Yes” to Q38, please provide the following information…
a) Name of employer
b) Address of employer
i.
Street address, including any suite number
ii.
City
iii.
State
iv.
ZIP code
v.
Country
40. In what occupation do you intend to work in the US?
41. Have you had any other jobs? (Circle one.)
a) Yes
b) No  Skip to Q43
42. In you answered “Yes” to Q41, please provide the following for ALL employers over the last
10 years…
a) Employer’s name
b) Address, including
i.
Street number
ii.
State
iii.
Country
iv.
ZIP code
c) Phone number
d) Job title
e) Supervisor’s Name (if you know it)
f) Dates of employment (from when until when?)
43. Have you attended any educational institutions at a secondary level or above? (Circle one.)
a) Yes
b) No  Skip to 46
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44. If you answered “Yes” to Q42, what is the number of institutions you have attended?
45. If you answered “Yes” to Q42, please provide the following information for EACH institution
you’ve attended at a secondary level or above…
a) Name of the institution
b) Address, including…
i.
Street address
ii.
City
iii.
State
iv.
Country
c) Course of study
d) Type of degree or diploma
e) Dates of attendance
46. Have you belonged to, contributed to, or worked for any professional, social or charitable
organization? (Circle one.)
a) Yes  EXPLAIN. Provide name of organizations, your role, etc.
b) No
47. Do you have any specialized skills or training, such as firearms, explosives, nuclear, biological,
or chemical experience? (Circle one.)
a) Yes  EXPLAIN
b) No
48. Have you ever served in the military? (Circle one.)
a) Yes
b) No  Skip to Q50
49. If you answered “Yes” to Q48, please provide the following information…
a) Country where you served
b) Branch of service
c) Rank/position
d) Military specialty
e) Dates of service
50. 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? (Circle one.)
a) Yes  EXPLAIN
b) No
51. Can you speak and/or read language other than your native language? (Circle one.)
a) Yes  List all languages
b) No
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SECTION VI: INFORMATION ABOUT PETITIONER
52. What is the petitioner’s relationship to you?
53. What is the petitioner’s full name? (First, last and middle)
54. What is the petitioner’s current address? Please include…
a) Street address, including any apartment number
b) City
c) State
d) ZIP code
e) Country
55. What is the petitioner’s phone number?
56. What is the petitioner’s e-mail address?
SECTION VII: SECURITY AND BACKGROUND INFORMATION (OF VISA APPLICANT)
[**Instructions: Please answer YES or NO to all of the following questions. If you answer “Yes”
to any of them, please explain.]
57. Do you have a communicable disease of public significance such as tuberculosis (TB)?
58. Do you have documentation to establish that you have received vaccinations in accordance with
US laws?
59. 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?
60. Are you or have you ever been a drug abused or addict?
61. Have you ever been arrested or convicted for any offense or crime, even though subject of a
pardon, amnesty, or other similar action?
62. Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled
substances?
63. Are you the spouse, son, or daughter of an individual who has violated any controlled substance
trafficking law, and have knowingly benefited from the trafficking activities in the past five
years?
64. 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?
65. Have you ever been involved in, or do you seek to engage in, money laundering?
66. Have you ever committed or conspired to commit a human trafficking offense in the United
States or outside the United States?
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67. Have you ever knowingly aided, abetted, assisted, or colluded with 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?
68. 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?
69. Do you seek to engage in espionage, sabotage, export control violations, or any other illegal
activity while in the United States?
70. Do you seek to engage in terrorist activities while in the United States or have you ever engaged
in terrorist activities?
71. Have you ever or do you intend to provide financial assistance or other support to terrorists or
terrorist organizations?
72. Are you a member or representative of a terrorist organization?
73. Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide?
74. Have you ever committed, ordered, incited, assisted, or otherwise participated in torture?
75. Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings,
political killings, or other acts of violence?
76. Have you ever engaged in the recruitment of or the use of child soldiers?
77. Have you, while serving as a government official, been responsible for or directly carried out, at
any time, particularly severe violations of religious freedom?
78. Are you a member of or affiliated with the Communist or other totalitarian party?
79. Have you ever directly or indirectly assisted or supported any of the groups in Columbia known
as the Revolutionary Armed Forces of Columbia (FARC), National Liberation Army (ELN), or
United Self-Defense Forces of Columbia (AUC)?
80. 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?
81. 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?
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82. 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 choice?
83. Have you ever disclosed or trafficked in confidential U.S. business information obtained in
connection with U.S. participation in the Chemical Weapons Convention?
84. 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?
85. 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?
86. Have you ever been the subject of a removal or deportation hearing?
87. Have you failed to attend a hearing on removability or inadmissibility within the last five years?
88. Have you ever been unlawfully present, overstayed the amount of time granted by an immigration
official or otherwise violated the terms of a U.S. visa?
89. Are you subject to a civil penalty under INA 274C? (penalties for document fraud)
90. Have you been ordered removed from the U.S. during the last five years?
91. Have you been ordered removed from the U.S. for a second time within the last 20 years?
SECTION VII: MISCELLANEOUS
[**Instructions: Please answer YES or NO to all of the following questions. If you answer “Yes”
to any of them, please explain.]
92. 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?
93. Have you ever intentionally assisted another person in withholding custody of a U.S. citizen child
outside the United States from a person granted legal custody by a U.S. court?
94. Have you voted in the United States in violation of any law or regulation?
95. Have you ever renounced United States citizenship for the purpose of avoiding taxation?
96. Have you attended a public elementary school or a public secondary school on student (F) status
after November 30, 1996 without reimbursing the school?
97. Do you seek to enter the United States for the purpose of performing skilled or unskilled labor but
have not yet been certified by the Secretary of Labor?
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98. 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?
99. Are you a health care 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?
100. Are you permanently ineligible for U.S. citizenship?
101. Have you ever departed the United States in order to evade military service during a time of war?
102. Are you coming to the U.S. to practice polygamy?
103. Are you a former exchange visitor (J) who has not yet fulfilled the two-year foreign residence
requirement?
104. Has the Secretary of Homeland Security of the United States ever determined that you knowingly
made a frivolous application for asylum?
105. Are you likely to become a public charge after you are admitted to the United States?
SECTION VIII: SOCIAL SECURITY NUMBER INFORMATION
106. Have you ever applied for a Social Security number? (Circle one.)
a) Yes
b) No  Skip to Q109
107. If you answered “Yes” to Q106, were you issued a number? (Circle one.)
a) Yes
b) No  Skip to Q110
108. If you answered “Yes” to Q107, please provide your Social Security Number
a) Do you need a new card issued? (Circle one.)
i.
Yes  Skip to Q110
ii.
No  Skip to Q110
109. If you answered “No” to Q106, do you want the Social Security Administration to issue a Social
Security number and a card? (Circle one.)
a) Yes
b) No
110. Do you authorize disclosure of information from this form to the Department of Homeland
Security, the Social Security Administration, and such other U.S. Government agencies as may be
required for the purposes of assigning you a social security number (SSN) and issuing you a
Social Security card and do you authorize the Social Security Administration to share your SSN
with the Department of Homeland Security? (Circle one.)
a) Yes
b) No
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