USA Visa Application Form (B1/B2)

Full Name (As in Passport):

Have you used other names? (Maiden, alias, etc.)

Yes

No

Date of Birth:

Gender:

Marital Status:

Nationality:

Place of Birth (City, Country):

Passport Number:

Country of Issuance:

Passport Expiry Date:

Have you ever lost or had your passport stolen?

Yes

No

Email:

Phone Number:

Current Address:

City, State, Country:

Have you lived at another address in the past 5 years?

Yes

No

Father's Full Name:

Is your father currently in the USA?

Yes

No

Mother's Full Name:

Is your mother currently in the USA?

Yes

No

Do you have immediate family (spouse, child, sibling) in the USA?

Yes

No

Current Occupation:

Employer Name (If any):

Employer Address:

Position:

Start Date:

Jobs held in the last 5 years:

Visa Type:

Have you made travel plans?

Yes

No

Who will cover your travel expenses?

Have you visited the U.S. before?

Yes

No

Have you applied for a U.S. visa before?

Yes

No

Have you ever overstayed your U.S. visa?

Yes

No

Have you applied for U.S. immigration?

Yes

No

Answer Yes/No and explain if necessary.

Have you ever been arrested or convicted of a crime?

Yes

No

Have you violated U.S. immigration laws?

Yes

No

Have you participated in terrorist activities?

Yes

No

Have you engaged in human trafficking or drug trade?

Yes

No

Have you participated in espionage, sabotage, or genocide?

Yes

No

Do you have a communicable disease?

Yes

No

Do you have a mental disorder that may pose a threat to others?

Yes

No

Are you traveling with someone?

Yes

No

Do you have a reference person or organization in the U.S.?

Yes

No

Emergency Contact Name:

Emergency Phone Number:

Relationship:

I declare that the information provided is true and accurate.

I accept the terms and conditions.

I understand that providing false information may lead to visa refusal.

USA Visa Application Form (B1/B2)
USA Visa Application Form (B1/B2)

1. Personal Information

2. Passport Details

3. Contact Information

4. Family Details

5. Employment Details

6. Travel Information

7. Previous Travel History

8. Security & Background

9. Travel Companions & Sponsor

10. Emergency Contact

11. Declaration & Consent