Form: U.S. B1/B2 Visa

U.S. B1/B2 Visa

Please accurately complete the application form, as below. We will then process your application and assist you as soon as possible!

- Step 1 of 11

Name of US consulate you would like to apply through? *

Which category visa are you applying for? *

Surname at Birth *

Full Name as per Passport *

First

Middle

Last

Gender *

Date of Birth *

City of Birth *

Country of Birth *

Marital Status *

Identity Number *

Do you have residence in any other country? *

Travel Document Number *

Travel Document Date of Issue *

Travel Document Date of Expiry *

Travel Document Issuing Authority *

Do you have any other passports? *

NB: If 'Yes', comment as below.

Other Passwords: Provide Details?

Current Residential Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Same Mailing Address? *

Home Telephone Number

Cell Phone Number *

Email *

Date of Arrival

Date of Departure

Full Name of a US Contact *

First

Middle

Last

US Contact: Cell/ Mobile Number? *

US Contact: Email Address? *

US Contact: Address? *

Address Line 1

Address Line 2

City

State

Zip Code

Add/ List past dates of last US trips in past 5 years?

Date:

Last US Visa Number:

Provided your last US Visa Number, if applicable?

Issue Date:

Expiry Date:

Other Countries Travelled - Have you travelled to another country in the last 5 years? *

Add/ List Other countries you have travelled to in the last 5 years, if applicable?

Country:

Please list any other country you travelled to in the last 5 years.

Will you be staying at a Private Residence or Hotel? *

Address where you will stay whilst in this country *

Address Line 1

Address Line 2

City

State

Zip Code

Will anyone be accompanying you on your trip? *

List all people accompanying you on your trip

Current Occupation *

Total Monthly Income *

Including other forms income - Specify currency & amount for monthly income?

Employer/ Educational Institution Name *

Employer/ Educational Institution Contact Number *

What is your start date with your employer? *

Monthly Salary *

Specify currency & amount for monthly income?

Current Employment Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Previous Employer: Company/ Organization Name *

Supervisor's Name at Previous Employer *

First

Last

Previous Employer Contact Number *

Designation at Previous Employer *

Start Date with Previous Employer *

End Date with Previous Employer *

Previous Employment Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Do you have a Higher Education? *

Name of Institution #1

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Name of Subject

Date Started

Date Ended

Name of Institution #2

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Name of Subject *

Date Started

Date Ended

Person/ Entity/ Company Paying for your Travels *

Sponsoring Person/ Entity/ Company Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Sponsoring Person/ Entity/ Company Contact Number:

Sponsoring Person/ Entity/ Company Contact Email:

Are you Married? *

NB: If Yes, complete your spouse's details below.

Spouse's Full Name

First

Middle

Last

Spouse's Date of Birth (DOB):

Spouse's Passport Number:

Spouse's Nationality:

Mother's Full Name & Surname *

First

Last

Mother Nationality *

Mother's Date of Birth *

Is your Mother's currently living in the USA? *

Father's Full Name & Surname *

First

Last

Father's Nationality *

Father's Date of Birth *

Is your Father currently living in the USA? *

Do you have any other relatives living in the US? *

Relative #1: Name & Surname

First

Last

Relative #1: Date of Birth

Relative #2: Name & Surname

First

Last

Relative #2: Date of Birth

Are you Divorced?

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 others 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 or welfare of yourself or others? *

Are you or have you ever been a drug abuser or addict? *

Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty, or other similar action? *

Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substances? *

Are you coming to this country to engage in prostitution or unlawful commercialized vice 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? *

Have you ever committed or conspired to commit a human trafficking offense in this country or outside this country? *

Are you the spouse, son, or daughter of an individual who has committed or conspired to commit a human trafficking offense in this country or outside this country 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 or conspired to commit a severe human trafficking offense in this country or outside this country? *

Do you seek to engage in espionage, sabotage, export control violations, or any other illegal activity while in this country? *

Do you seek to engage in terrorist activities while in this country or have you ever engaged in terrorist activities? *

Are you a member or representative of a terrorist organization? *

Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide? *

Have you ever committed, ordered, incited, assisted, or otherwise participated in torture? *

Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings, political killings, or other acts of violence? *

Have you ever engaged in the recruitment or the use of the child soldiers? *

Have you, while serving as a government official, been responsible for or directly carried out, at any time, particularly severe violations of religious freedom? *

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? *

Have you ever been directly involved in the coercive transplantation of human organs or bodily tissue *

Have you ever been the subject of a removal or deportation hearing *

Have you ever sought to obtain or assist others to obtain a visa, entry into this country, or any other country 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 years? *

Have you ever been unlawfully present, overstayed the amount of time granted by an immigration official or otherwise violated the terms of this country's visas? *

Have you ever withheld custody of a child outside any country from a person granted legal custody by this country's court? *

Have you voted in this country in violation of any law or regulation? *

Have you attended a public elementary school on student (F) status or a public secondary school after November 30, 1996 without reimbursing the school? *

Do you have a social media presence? *

Please list below each social platform you have used within the last five years. In the space next to the platform's name, enter the username or handle you have used on that platform. Please do not provide your passwords. If you have used more than one platform or more than one username or handle on a single platform, please make sure to list each one separately. If you have not used any social media platforms in the last five years, enter "None".

Social Platform #1

NB: Insert details if applicable.

Username/ Handle #1

Social Platform #2

NB: Insert details if applicable.

Username/ Handle #2

Comment or Message:

NB: Any additional information required for swift application processing.

US Visa Declaration: *

I confirm that the information given in this form is true, complete and accurate.

Acknowledgement *

I hereby acknowledge that I am aware that refusals of visa applications are solely at the discretion of the Consulate for the country I am are applying to. Visa Time will not be responsible for decisions hereto and no refunds are applicable - T&C's Apply.

Vista Time Disclosure: *

“I hereby confirm that all information has been fully & accurately completed to the best of my knowledge. I accept all T&C's & understand additional fees may apply, if extended services are required over & above the standard application process.”