US VISA APPLICATION DS-160
PERSONAL INFORMATION
Application Date
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Month
-
Day
Year
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Full Name
*
First Name
Last Name
Have you used other names before
YES
NO
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
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Anguilla
Antigua and Barbuda
Argentina
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Aruba
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The Bahamas
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Belarus
Belgium
Belize
Benin
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Bolivia
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Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
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Croatia
Cuba
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Democratic Republic of the Congo
Denmark
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Morocco
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Namibia
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New Caledonia
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Portugal
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Romania
Russia
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Saint Lucia
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Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
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Trinidad and Tobago
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Ukraine
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Uruguay
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Vanuatu
Vatican City
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Vietnam
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Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Day Time Phone
*
-
Area Code
Phone Number
E-mail
*
DOB
*
-
Month
-
Day
Year
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Place of Birth
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
SEX
*
MARITAL STATUS
*
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Nationality
*
Do you hold or have held any other nationality
*
Yes No
Are you a Permanent Resident of nay other country
*
Yes No
US SSN Number
*
National ID Number
*
US Tax ID Number
*
TRAVEL INFORMATION
Purpose of your trip to the US
*
Business Pleasure
Have you made specific travel plans
YES
NO
Intended Date of Travel
-
Month
-
Day
Year
Date Picker Icon
Intended length of stay
Address you will be staying in the US
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Person / entity paying for your trip
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TRAVEL COMPANIONS INFORMATION
Are there other persons travelling with you
YES
NO
PREVIOUS US TRAVEL INFORMATION
Have you ever been in the US
YES
NO
Have you been issued a US visa
YES
NO
Have you ever been refused a visa or admission in the US
YES
NO
Have anyone ever filed a petition on your behalf with the United States Citizenship and immigration services
YES
NO
ADDRESS AND PHONE INFORMATION
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is your mailing address the same as your home address
YES
NO
Other
Primary Telephone Number
-
Area Code
Phone Number
Secondary Telephone Number
-
Area Code
Phone Number
Work Telephone Number
-
Area Code
Phone Number
Have you used any other phone numbers in the last five years
Email Address
Have you used any other email address in the last five years
Additional Email Address
May we contact this employer? (please check one)
YES
NO
If NO, reason why not
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Please provide all social media provider/ platforms for the past five years
Please provide all social media identifier for the last five years
Do you wish to provide information about your presence on other websites for the past five years
YES
NO
PASSPORT INFORMATION
Travel Document / Passport Type
eg: Regular, Official, Diplomatic, other
Travel Document Number
Country that issue Passport/ Travel Document
Where was the document issued
Address
Street Address
City
State / Province
Postal / Zip Code
Issuance Date
-
Month
-
Day
Year
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Expiration Date
-
Month
-
Day
Year
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Have you ever had a Passport lost or stolen
YES
NO
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US POINT OF CONTACT
Contact person or Organization the US
Full Name
*
First Name
Last Name
Organization name
Relationship to you
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Telephone
*
-
Area Code
Phone Number
Email Address
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FAMILY INFORMATION/ RELATIVE
Father's Full Name and DOB
*
First Name
Last Name
Date OF BIRTH
-
Month
-
Day
Year
Date Picker Icon
Is your Father in the US
Mother's Full Name and DOB
*
First Name
Last Name
Date OF BIRTH
-
Month
-
Day
Year
Date Picker Icon
Is your Mother in the US
Do you have immediate Relative not including your Parents in the US
YES
NO
Do you have other Relative in the US
YES
NO
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PRESENT WORK/ EDUCATION/TRAINING INFORMATION
Primary Occupation
Present Employer or School Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Start Date
-
Month
-
Day
Year
Date Picker Icon
Montly income if employed
Briefly describe your duties
Were you previously employed
YES
NO
Have you attended any education institution at a secondary level or above
YES
NO
Name of institution
Start Date
-
Month
-
Day
Year
Date Picker Icon
End Date
-
Month
-
Day
Year
Date Picker Icon
Name of institution
Start Date
-
Month
-
Day
Year
Date Picker Icon
End Date
-
Month
-
Day
Year
Date Picker Icon
Name of institution
Start Date
-
Month
-
Day
Year
Date Picker Icon
End Date
-
Month
-
Day
Year
Date Picker Icon
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SECURITY AND BACKGROUND CHECK
Do you belong to a Clan or Tribe
YES
NO
Provide a list of Languages you speak
Have you traveled to any Country/Region in the last five years
YES
NO
Have you belonged to contribute to or worked for any professional or charitable Organization
YES
NO
Do you have any specialized skills or training such as firearms, explosive, nuclear, biological or chemical experiences
YES
NO
Have you ever served in the military
YES
NO
Have you ever served in been a member of or being involved with a Paramiltary unit, Vigilante unit Rebel Group, Guerilla Group or Insurgent Organization
YES
NO
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Jamaican Visa Application Fee
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260.00
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