Personal Information 1 - ATENEA PROGRAMAS DE INTERCAMBIO

Transcripción

Nonimmigrant Visa - Personal Information 1
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Online Nonimmigrant Visa Application (DS-160)
Application ID AA001WXW4F
Personal Information 1
OMB CONTROL NUMBER: 1405-0182
Recuerda que todos los datos que
registres en este formulario deben
estar de acuerdo a tu pasaporte.
FORM NUMBER:
DS-160
EXPIRATION DATE: 04/30/2014
ESTIMATED BURDEN:
75 MIN
NOTE: Data on this page must match the information as it is written in your passport.
Surnames
llaque aranguri
Apellidos completos.
(e.g., FERNANDEZ GARCIA)
Given Names
Nombres completos.
rafael david
(e.g., JUAN MIGUEL)
Full Name in Native Alphabet
Does Not Apply/Technology Not Available
Help: Surnames
Enter all surnames as listed in your passport. If only one name is listed in your passport, enter that Surname.
Help: Given Names
If your passport does not include a given name, please enter 'FNU' in Given Names.
Have you ever used other names (i.e., maiden, religious, professional, alias, etc.)?
Yes No
No.
Help: Other Names
Other names used include your maiden name, religious name, professional name, or any other names which you are known by or have
been known by in the past.
Do you have a telecode that represents your name?
Yes No
No.
Help: Telecode
Telecodes are 4 digit code numbers that represent characters in some non-Roman alphabet names.
Sex
Elige tu género.
Male Female
Marital Status
SINGLE
Date and Place of Birth
Elige tu status, soltero, casado, etc.
Date of Birth
https://ceac.state.gov/GENNIV/General/complete/complete_personal.aspx?node=Pers... 10/10/2011
18
APR
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Fecha de nacimiento de acuerdo a tu pasaporte.
1992
(Format: DD-MMM-YYYY)
City of Birth
trujillo
Ciudad de nacimiento.
State/Province of Birth
la libertad
Departamento de nacimiento.
Does Not Apply
Place of Birth
País de nacimiento.
PERU
Help: Date of Birth
If day or month is unknown, enter as shown in passport.
Help: Place of Birth
Select the name that is currently in use for the place where you were born.
Public reporting burden for this collection of information is estimated to average 75 minutes per response, including time required for searching
existing data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final
collection. You do not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on
the accuracy of this burden estimate and/or recommendations for reducing it, please send them to: A/ISS/DIR, Room 2400 SA-22, U.S.
Department of State, Washington, DC 20522-2202
INA Section 222(f) provides that the records of the Department of States and of diplomatic and consular offices of the United States pertaining to the
issuance and refusal of visas or permits to enter the United States shall be considered confidential and shall be used only for the formulation,
amendment, administration, or enforcement of the immigration, nationality, and other laws of the United States. Certified copies of such records may
be made available to a court provided the court certifies that the information contained in such records is needed in a case pending before the court.
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Personal Information 2
Nationality
PERU
Nacionalidad
.
Do you hold or have you held any nationality other than the one indicated above on nationality?
Si tienes otra nacionalidad.
Yes No
National Identification Number
Número de tu DNI.
43356789
Does Not Apply
U.S. Social Security Number
Does Not Apply
U.S. Taxpayer ID Number
- Si viajas por primera vez: Selecciona Does Not Apply.
- Si viajaste antes como W&T: Registra tu número de
Social Security Card.
Seleccionar Does Not Apply.
Does Not Apply
Help: Identification Numbers
Your National ID Number is a unique number that your government provides. The U.S. Government provides unique numbers to those
who seek employment (Social Security Number) or pay taxes (Taxpayer ID).
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Nonimmigrant Visa - Address and Phone Information
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Address and Phone Information
Home Address
Dirección actual (aunque no coincida con tu DNI), sin
abreviaturas y sin traducir al inglés. Empezar por calle,
jirón o avenida, luego el número y la urbanización.
Street Address (Line 1)
los sauces 792 urbanizacion california
Street Address (Line 2) *Optional
City
trujillo
Si no te alcanza todo en el primer
renglón, continuar en este.
Ciudad.
State/Province
la libertad
Departamento.
Does Not Apply
Postal Zone/ZIP Code
Does Not Apply
Country
PERU
Para Lima, escribir el código
postal de tu distrito.
Para el resto de ciudades:
Does Not Apply.
País.
Mailing Address
Is your Mailing Address the same as your Home Address?
Yes No
Yes.
Teléfono fijo de tu casa (código de país: 51, seguido
del código de tu ciudad, seguido del número de tu
teléfono fijo. Sin ceros.
Phone
Primary Phone Number
5144423962
Secondary Phone Number
Does not apply.
Does Not Apply
Work Phone Number
Does not apply.
Does Not Apply
Help: Phone
You must provide a primary phone number. The primary phone number should be the phone number at which you are most likely to be
reached; this could be a land line or a cellular/mobile number. If you have an additional land line or a cellular/mobile number please list
that as your secondary phone number.
Email Address
Tu correo electrónico.
Email Address
[email protected]
Does Not Apply
(e.g., [email protected])
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Nonimmigrant Visa - Passport Information
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Passport Information
Help: Passport/Travel Document Number
Enter the information on the travel document you will be using when traveling to the U.S. Your travel document should be a valid,
unexpired passport or other valid, unexpired documentation that is sufficient to establish your identity and nationality.
REGULAR
Passport/Travel Document Type
Passport/Travel Document Number
23456
Número de tu pasaporte.
Help: Passport Book Number
The Passport Book Number is commonly called the inventory control number. You may or may not have a Passport Book Number on
your passport. The location of the Passport Book Number on your passport may vary depending on the country that issued your
passport. Please contact your passport issuing authority if you are unable to determine whether or not your passport contains a Passport
Book Number.
Does Not Apply.
Passport Book Number
Does Not Apply
Country/Authority that Issued Passport/Travel Document
PERU
Where was the Passport/Travel Document Issued?
Ciudad de emisión de tu pasaporte.
City
trujillo
State/Province *If shown on passport
Departamento de emisión de tu pasaporte.
la libertad
Country
PERU
País de emisión de tu pasaporte.
Issuance Date
15
APR
2011
Fecha de emisión de tu pasaporte.
Help: Expiration Date
In most cases your passport/Travel Document must have at least six months of validity beyond the date of your visa application and/or
your arrival in the United States.
Fecha de expiración de tu pasaporte.
Expiration Date
15
APR
2015
Does Not Apply
Have you ever lost a passport or had one stolen?
Si perdiste un pasaporte.
Yes No
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Nonimmigrant Visa - Travel Information
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Travel Information
NOTE: Provide the following information concerning your travel plans.
Provide the following information:
Purpose of Trip to the U.S.
EXCHANGE VISITOR (J)
Propósito de viaje.
EXCHANGE VISITOR (J1)
Specify
Visita de intercambio.
Add Another
Remove
Have you made specific travel plans?
No.
Yes No
Intended Date of Arrival
12
DEC
2011
Intended Length of Stay in U.S.
3
Month(s)
Help: Arrival Plans
Fecha de viaje, 2 días antes del
inicio de tu contrato de trabajo.
Registra el tiempo que permanecerás en
EE.UU., incluye sólo la duración de tu contrato
de trabajo.
If you are unsure of your travel plans, please provide an estimate.
Address Where You Will Stay in the U.S.
EOK PARK ST 566
EOK PARK
Dirección de tu empleador, lo
encuentras en tu Job Offer.
City
LUXE
Ciudad.
State
ILLINOIS
Estado.
ZIP Code (if known)
12345
Código Postal.
(e.g., 12345 or 12345-1234)
Person/Entity Paying for Your Trip
Other Person
Other Person.
Provide the following information:
Surnames of Person Paying for Trip
LLAQUE PAREDES
Apellidos de tu papá.
(e.g., FERNANDEZ GARCIA)
Given Names of Person Paying for Trip
RAFAEL
(e.g., JUAN MIGUEL)
Telephone Number
5144423962
Email Address
Nombres de tu papá.
Número de teléfono fijo de tu casa (el mismo que
pusiste en Phone Information, incluyendo código
de país y ciudad).
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10/10/2011
Nonimmigrant Visa - Travel Information
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Correo electrónico de tu papá.
[email protected]
Does Not Apply
Relationship to You
Parent.
PARENT
Is the address of the party paying for your trip the same as your Home or Mailing Address?
Yes.
Yes No
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10/10/2011
19/10/2011
Nonimmigrant Visa - Travel Companio…
Application ID AA001WWTC9
Travel Companions Information
NOTE: Provide the following travel companion information.
Persons traveling with you
Are there other persons traveling with you?
Yes.
Yes No
Help: Traveling with Others
You should answer Yes to this question if you are traveling with family, as part of an organized tour, or as part of a performing
group or athletic team. You do not need to list individuals who are traveling with you for the purposes of employment with the same
employer.
Are you traveling as part of a group or organization?
Yes.
Yes No
Enter the name of the group you are traveling with
Group Name
ATENEA PROGRAMAS DE INTERCAMBIO
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Atenea Programas
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Nonimmigrant Visa - Previous U.S. Travel Information
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Previous U.S. Travel Information
NOTE: Provide the following previous U.S. travel information. Provide complete and accurate information to all questions that require an
explanation.
Have you ever been in the U.S.?
Has viajado antes
a Estados Unidos?
Yes No
Provide information on your last five U.S. visits:
Date Arrived
15
DEC
Si tu respuesta es SI: Completar la fecha
de arribo a EE.UU. y el tiempo que
permaneciste.
Si has estado más de una vez en
EE.UU., registrar todas, desde la más
reciente hacia la más antigua.
2010
Length of Stay
3
Month(s)
Add Another
Remove
Do you or did you ever hold a U.S. Driver’s License?
Tramitaste licencia
de conducir en
EE.UU.?
Yes No
Help: Previous U.S. Visits
If you are unsure about when you visited the U.S., please provide a best estimate.
Have you ever been issued a U.S. Visa?
Te han emitido visa para EE.UU. antes?
Yes No
Previous U.S. Visas
Date Last Visa Was Issued
12
OCT
2010
Si tu respuesta es SI, completar la fecha de
emisión y el número de tu última visa.
Visa Number
234567
Do Not Know
Are you applying for the same type of visa?
Yes No
Estas aplicando para el mismo tipo
de visa?
Are you applying in the same country where the visa above was issued and is this country your principal country of residence?
Estas aplicando en
el mismo país?
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Nonimmigrant Visa - Previous U.S. Travel Information
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Yes No
Tomaron tus 10 huellas digitales,
cuando tramitaste la visa anterior?
Have you been ten-printed?
Yes No
Has your U.S. Visa ever been lost or stolen?
Has perdido o te han robado un pasaporte
visado (con visa para EE.UU.)?
Yes No
Has your U.S. Visa ever been cancelled or
revoked?
Yes No
Te han cancelado una visa para
EE.UU.? (Se refiere a si la
tuviste y te la quitaron por algún
motivo.
Help: Visa Number
Enter the 8-digit number that is displayed in red on the lower right hand side of your visa. If your previous visa was a Border Crossing
Help:
Ten-printed
Card enter
the last 12-digit number of the first line of the machine readable zone.
Ten-printed means that you have provided fingerprints for all your fingers, as opposed to having provided only two fingerprints.
Have you ever been refused a U.S. Visa, been refused admission to the United States, or withdrawn your application for admission at
the port of entry?
Te han negado una visa o la
entrada a EE.UU.?
Yes No
Explain
Indicar el tipo de visa y el
año?
Tourism visa, 2005.
Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and Immigration Services?
Alguien ha gestionado una petición
a tu nombre en el servicio de
inmigrantes?
Yes No
Explain
Si la respuesta es
SI, detallar el año.
yes, 2009.
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Nonimmigrant Visa - U.S. Point of Contact Information
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U.S. Point of Contact Information
Datos de tu sponsor, los tienes
en tu DS 2019, en el punto 7.
Contact Person or Organization in the United States
Contact Person
Surnames
maloney
Apellidos de la persona que firma
el DS 2019.
Given Names
courtney
Nombres de la persona que firma
el DS 2019.
Do Not Know
Organization Name
spirit cultural exchange
Nombre de tu sponsor, lo tienes en el Punto 2 del
DS 2019.
Relationship to You
OTHER
Do Not Know
Other.
Help: Contact
Your U.S. Point of Contact can be any individual in the U.S. who knows you and can verify, if necessary, your identity. If you do not
personally know anyone in the U.S., you may enter the name of the store, company, or organization you plan to visit during your trip.
Address and Phone Number of Point of Contact
U.S. Street Address (Line 1)
137 north oak park avenue suite 304
Dirección de tu
sponsor.
U.S. Street Address (Line 2) *Optional
City
oak park
State
ILLINOIS
60301
ZIP Code (if known)
(e.g., 55555 or 55555-5555)
Phone Number
(708)763-8940
Número de teléfono de tu sponsor.
(e.g., (555)555-5555)
Email Address
Email del Manager
del sponsor.
[email protected]
Does Not Apply
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Nonimmigrant Visa - Family Information: Relatives
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Family Information: Relatives
NOTE: Please provide the following information concerning your biological parents. If you are adopted, please provide the following
information on your adoptive parents.
Father's Full Name and Date of Birth
Apellidos completos de tu papá.
Surnames
llaque paredes
(e.g., Hernandez Garcia)
Nombres completos de tu papá.
Given Names
rafael rodolfo
Do Not Know
(e.g., Juan Miguel)
Do Not Know
Date of Birth
28
MAR
Fecha de nacimiento de tu papá.
1960
Do Not Know
Is your father in the U.S.?
Se encuentra tu padre en Estados Unidos? Si la
respuesta es SI, registrar su status.
Yes No
Mother's Full Name and Date of Birth
Surnames
aranguri lopez
Apellidos completos de tu mamá.
(e.g., Hernandez Garcia)
Do Not Know
Nombres completos de tu mamá.
Given Names
teresa jimena
(e.g., Juanita Miguel)
Do Not Know
Date of Birth
03
APR
Fecha de nacimiento de tu mamá.
1965
Do Not Know
Is your mother in the U.S.?
Yes No
Se encuentra tu madre en Estados Unidos? Si la
respuesta es SI, registrar su status.
Do you have any immediate relatives, not including parents, in the United States?
Tienes familiares en Estados Unidos, responder si, sólo
si son tus hermanos de padre y madre.
Yes No
Help: Immediate Relatives
Means fiancé/fiancée, spouse (husband/wife), child (son/daughter), or sibling (brother/sister).
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Nonimmigrant Visa - Present Work/Education/Training Information
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Present Work/Education/Training Information
NOTE: Provide the following information concerning your current employment or education.
Primary Occupation
Student
STUDENT
Present Employer or School Name
universidad privada del norte
Nombre completo de tu universidad.
Present employer or school address:
avenida de el ejercito 920
Dirección completa de tu universidad, sin traducción al
inglés, sin abreviaturas, sin símbolos (Nº, #). Si no te
alcanza en el primer renglón continua en el segundo.
urbanizacion el molino
Ciudad.
City
trujillo
Departamento.
State/Province
la libertad
Does Not Apply
Para Lima: Usar el código postal del distrito en el
que se ubica la universidad.
Para otras ciudades: Does Not Apply.
Does Not Apply
Phone Number
5144220062
Número de teléfono de tu
universidad.
Country
PERU
Monthly Income in Local Currency (if employed)
PERU.
Does Not Apply
Briefly describe your duties:
regular student
Does Not Apply.
Regular Student.
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Responder SI, sólo si has viajado como
Work and Travel en temporadas
anteriores.
Nombre de tu
empleador.
Dirección de tu
empleador.
Ciudad.
Estado.
Código postal.
País.
Número de teléfono.
Puesto que desempeñaste.
Apellidos de tu supervisor.
Nombres de tu supervisor.
Fecha de inicio de tu Job Offer.
Fecha de término de tu Job Offer.
Describe tus
funciones.
SI. Registrar los datos de tu colegio (Nivel Secundario).
Nombre de tu colegio.
Dirección de tu colegio.
Ciudad.
Departamento.
Para Lima: Código postal del distrito al que pertenece.
Para otras ciudades: Does Not Apply.
País.
Academic.
Fecha de inicio de tu primer año en secundaria.
Fecha de término de tu quinto año en secundaria.
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Nonimmigrant Visa - Additional Work/Education/Training Information
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Additional Work/Education/Training Information
NOTE: Provide the following work, education, or training related information. Provide complete and accurate information to all questions
that require an explanation.
Do you belong to a clan or tribe?
Yes No
No.
Provide a List of Languages You Speak
Language Name
spanish
Add Another
Remove
Registrar los idiomas que hablas: Empezando por el
español, luego inglés y los demás. Para agregar los
demás idiomas hacer click en Add Another.
Language Name
english
Add Another
Remove
Have you traveled to any countries within the last five years?
Yes No
Provide a List of Countries Visited
Responder de acuerdo a tu perfil, si la
respuesta es si, registrar el nombre del o los
países que visitaste.
Countries
BRAZIL
Add Another
Remove
Have you belonged to, contributed to, or worked for any professional, social, or charitable organization?
Yes No
No.
Do you have any specialized skills or training, such as firearms, explosives, nuclear, biological, or chemical experience?
Yes No
No.
Have you ever served in the military?
Yes No
No.
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?
Yes No
No.
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Nonimmigrant Visa - Security and Background: Part 1
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Security and Background: Part 1
NOTE: Provide the following security and background information. Provide complete and accurate information to all questions that
require an explanation. A visa may not be issued to persons who are within specific categories defined by law as inadmissible to the
United States (except when a waiver is obtained in advance). Are any of the following applicable to you? While a YES answer does not
automatically signify ineligibility for a visa, if you answer YES you may be required to personally appear before a consular officer.
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.)
Yes No
No.
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?
Yes No
No.
Are you or have you ever been a drug abuser or addict?
Yes No
No.
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NOTE: Provide the following security and background information. Provide complete and accurate answers to all questions that require
an explanation. A visa may not be issued to persons who are within specific categories defined by law as inadmissible to the United
States (except when a waiver is obtained in advance). Are any of the following applicable to you? While a YES answer does not
Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty, or other similar action?
No.
Yes No
Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substances?
Yes No
No.
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?
Yes No
No.
Have you ever been involved in, or do you seek to engage in, money laundering?
Yes No
No.
Have you ever committed or conspired to commit a human trafficking offense in the United States or outside the United States?
Yes No
No.
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?
Yes No
No.
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?
Yes No
No.
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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?
Yes No
No.
Do you seek to engage in terrorist activities while in the United States or have you ever engaged in terrorist activities?
No.
Yes No
Have you ever or do you intend to provide financial assistance or other support to terrorists or terrorist organizations?
Yes No
No.
Are you a member or representative of a terrorist organization?
Yes No
No.
Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide?
Yes No
No.
Have you ever committed, ordered, incited, assisted, or otherwise participated in torture?
Yes No
No.
Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings, political killings, or other acts of
violence?
Yes No
No.
Have you ever engaged in the recruitment or the use of child soldiers?
Yes No
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?
Yes No
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?
Yes No
No.
Have you ever been directly involved in the coercive transplantation of human organs or bodily tissue?
Yes No
No.
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Have you ever been the subject of a removal or deportation hearing?
Yes No
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?
Yes No
No.
Have you failed to attend a hearing on removability or inadmissibility within the last five years?
Yes No
No.
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?
Yes No
No.
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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?
No.
Yes No
Have you voted in the United States in violation of any law or regulation?
Yes No
No.
Have you ever renounced United States citizenship for the purposes of avoiding taxation?
Yes No
No.
Have you attended a public elementary school on student (F) status or a public secondary school after November 30, 1996 without
reimbursing the school?
Yes No
No.
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Nonimmigrant Visa - Additional Point of Contact Information
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Additional Point of Contact Information
NOTE: You have indicated that you will be studying in some capacity while in the United States. List at least two contacts in your
country of residence who can verify the information that you have provided on this application. Do not list immediate family members or
other relatives. Postal office box numbers are unacceptable.
Surnames
reyes garcia
Given Names
fabiola sofia
avenida larco 234 urbanizacion el recreo
Apellidos del
primer contacto.
Nombres del
primer contacto.
City
trujillo
Dirección completa
del primer contacto.
Registrar 2 personas de contacto, no
familiares, mayores de 18 años, que
vivan en tu misma ciudad, no
necesariamente deben hablar inglés,
pero deben conocer la información
que estas llenando en este formulario
para dar referencia de tu persona.
State/Province
la libertad
Does Not Apply
Does Not Apply
Country
PERU
Telephone Number
5144342567
Does Not Apply
Número de teléfono fijo del
primer contacto.
Email Address
[email protected]
Does Not Apply
Add Another
Remove
Email del primer
contacto.
Surnames
gamero cordova
Given Names
edith paola
avenida husares de junin 238
urbanizacion el recreo
Apellidos del
segundo contacto.
Nombres del
segundo contacto.
City
trujillo
State/Province
la libertad
Does Not Apply
Dirección completa del
segundo contacto.
Does Not Apply
Country
PERU
Telephone Number
5144678976
Does Not Apply
Email Address
Número de teléfono fijo del
segundo contacto.
https://ceac.state.gov/GENNIV/General/complete/complete_ExchangeVisitorAddCon... 10/10/2011
Nonimmigrant Visa - Additional Point of Contact Information
[email protected]
Email del segundo
contacto.
Does Not Apply
Add Another
Remove
Back: Security and Background
Página 2 de 2
Save
Next: SEVIS
Click para
continuar.
Guardar.
https://ceac.state.gov/GENNIV/General/complete/complete_ExchangeVisitorAddCon... 10/10/2011
Nonimmigrant Visa - SEVIS Information
Página 1 de 1
SEVIS Information
NOTE: You have indicated that the purpose of your trip to the U.S. is to be a student or exchange visitor. Provide the following
information regarding the institution at which you intend to study.
SEVIS ID
n2344555666
Número de sevis, lo tienes en la parte superior de
tu DS 2019, junto al código de barras.
(e.g., N0123456789)
Program Number
p-3-06087
Do you intend to study in the U.S.?
Yes No
Back: Additional Contact
Exchange Visitor Program Number: Código
que tienes en el punto 2 de tu DS 2019.
No.
Save
Next: PHOTO
Click para
continuar.
Guardar.
https://ceac.state.gov/GENNIV/General/complete/complete_ExchangeVisitorStudent...
10/10/2011
Nonimmigrant Visa - Upload Photo
Página 1 de 1
Upload Photo
Click on the Upload Your Photo button below to access our photo submission system. Once there you will be
given instructions on how to supply an approved photo for your Visa application. After you have selected the
photo to upload and the system verifies the photo is acceptable, you will return to “Confirm Photo” to
continue the application process.
Enviar consulta
Back: COMPLETE
Save
Save
Adjuntar el archivo de la
foto visa (el mismo que
probaste anteriormente).
Next:
Next: Confirm
Confirm Photo
Photo
https://ceac.state.gov/GENNIV/General/photo/photo_uploadthephoto.aspx?node=Upl... 10/10/2011
Upload Photo // U.S. Department of State
Página 1 de 1
Upload Photo
Photo Quality Standards
In order to ensure the highest quality photos will be used in the final printed travel document, the Department of State has created a
guide for you to use when creating and uploading your photos [see photo quality standards guide].
Select Your Photo
Click the "Browse" button and choose a JPEG format image (i.e., .jpg file type) that is 240 KB or less in file size.
Selected Photo:
Una vez adjuntada la foto, click para continuar, te
solicitará que revises la aplicación, verifica que
todos los datos ingresados estén correctos,
debes hacerlo rapidamente para evitar que la
aplicación caduque.
Photo:
Examinar...
This site is managed by the Bureau of Consular Affairs, U.S. Department of State. External links to other Internet sites should not be
construed as an endorsement of the views contained therein.



Copyright Information
Disclaimers
Paperwork Reduction Act
https://identix.state.gov/qotw/Upload.aspx?eKv7toMa91SCRQS4%2b8d77CbzbZXfk... 10/10/2011
Nonimmigrant Visa - Sign and Submit
Página 1 de 1
Sign and Submit
Read the following information carefully before dating, electronically signing and submitting the application. Your application is now ready to be submitted. Please note that this does not necessarily mean that your application for a nonimmigrant visa is
complete, as additional information may be needed after Department of State personnel have reviewed the application. By clicking “Sign and Submit Application” you are electronically signing the application. You are required to electronically sign your application
yourself, unless otherwise exempt by regulation, even if the application has been prepared by someone other than yourself. Your electronic
signature certifies that you have read and understood the questions in this application and that your answers are true and correct to the best of
your knowledge and belief. The submission of an application containing any false or misleading statements may result in the permanent refusal of
a visa or the denial of entry into the United States. All declarations made in this application are unsworn declarations made under penalty of
perjury. (28 U.S.C. 1746). The information that you have provided in your application and other information submitted with your application may be accessible to other
government agencies having statutory or other lawful authority to use such information, including for law enforcement and immigration law
enforcement purposes. The photograph that you provide with your application may be used for employment verification or other U.S. law
purposes. Human Trafficking Prevention
Pursuant to Section 202 of the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008 you are required to receive a
copy of an informational pamphlet on the legal rights and resources of aliens applying for employment- or education-based nonimmigrants
visas. Please read the pamphlet carefully. We strongly encourage you to print a copy of a pamphlet and keep it with you if your visa is
granted and you travel to the United States.
William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008 Pamphlet
I certify that I have viewed and read the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008 Pamphlet.
Monday, October 10, 2011 - 7:59:02 PM EST
Dar Click para activar el
check.
Preparer of Application
Did anyone assist you in filling out this application?
No.
Yes No
Número de tu pasaporte.
E-Signature
I certify under penalty of perjury under the laws of the United States of America that the foregoing is true and correct.
Enter your Passport/Travel Document Number:
24354
Registrar el código que aparece
en el recuadro negro.
Enter the code as shown:
pn5rf
Antes de dar click en
Submit, guardar
online
Click the
button below to electronically sign your application:
la aplicación.
Sign and Submit Application
Back: REVIEW
Save
Next: Confirmation
Dar click para enviar a la base
de datos de la embajada. A
partir de ese momento ya no
se puede realizar ningún
cambio.
Click para confirmar e imprimir la hoja de
confirmación, a colores y en impresora con muy
buena tinta. Guardar el archivo en tu PC local. Esa
hoja deberás llevarla el día de tu entrevista.
https://ceac.state.gov/GENNIV/General/esign/signtheapplication.aspx?node=SignCert... 10/10/2011

Personal Information 1 - ATENEA PROGRAMAS DE INTERCAMBIO

Transcripción

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