PAGE 1
City of Birth
Country/Region of Birth
Date of Birth
State/Province of Birth
Does Not Apply
Personal Information 1
Surnames
Given Names
Full Name in Native Alphabet
Does Not Apply/Technology Not Available
Have you ever used other names (i.e., maiden, religious, professional, alias,etc.)?
Yes No
Other Surnames Used (maiden, religious, professional, aliases, etc.)
Other Given Names Used
Sex:
Male Female
Current Marital Status:
If "Yes", Provide the following information:
Date and Place of Birth:
NOTE: Data on this page must matchthe information as it is written in yourpassport.
Help: SurnamesEnter all surnames as listed in yourpassport. If only one name is listed inyour passport, enter that Surname.
Help: Given NamesYour given name includes any firstname and any middle name that islisted in your passport or traveldocumentation. If your passport doesnot include a given name, pleaseenter 'FNU' in Given Names.
Help: Other Names UsedOther names used includes yourmaiden name, religious name,professional name, or any othernames which are known or have beenknown in the past.
Help: Other NamesIf you only have other surnames toenter, enter the same given names asabove. If you only have other givennames to enter, enter the samesurname as above.
Help: Date of BirthIf day or month is unknown, enter asshown in passport.
Use 2 digits for Day (example: 02)Use 4 digits for Year (example 1976)
Help: Country of BirthThe name of the country should bethe name that is currently in use forthe place where you were born.
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
(format: DD-MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Personal Information 2
Country/Region of Origin (Nationality)
Do you hold or have you held a nationality other than the one you haveindicated above?
Yes No
Other Country/Region of Origin (Nationality)
Add Another
If "Yes", Provide the following information:
Do you hold a passport from the country/region of origin(nationality) above?
Yes No
If "Yes", Provide the following information:
Passport Number
Help: Beneficiary IDEnter the Beneficiary ID provided toyou by the National Visa Center(NVC). Your ID is located on yourImmigrant Visa Fee ProcessingInvoice. If you are unable to locateyour Beneficiary ID, please contactthe NVC.
Please be sure to enter yourBeneficiary ID exactly as shown onyour Invoice. Do not enter someoneelse's Beneficiary ID as it will not beaccepted.
PAGE 2
Provide the following information on your traveldocumentation:
Document ID
Document Type
Country/Authority that Issued Document
Issuance Date Expiration Date
(format: DD-MMM-YYYY) (format: DD-MMM-YYYY)
Help: Travel DocumentationEnter the information on the traveldocument you will be using whentraveling to the U.S. Your traveldocument should be a valid,unexpired passport or other valid,unexpired documentation that issufficient to establish your identityand nationality. If you do not have apassport, contact NVC.
Help: Other NationalityEnter all nationalities you currentlyhold and all nationalities you havepreviously held, regardless ofwhether you have formally and/orlegally relinquished the nationality. Ifthe country where you previouslyheld nationality is no longer a politicalentity ot country, select the nationalitythat corresponds with the name of thecountry that is currently used for thatlocation.
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Started Living Here
Address Abroad )( Residence Address
Present and Previous Address InformationPresent Address
Street Address (Line 1)
Street Address (Line 2) *Optional
City
State/Province
Postal Zone/ZIP Code
Country
Does Not Apply
Does Not Apply
PAGE 3
Started Living Here
(format: MMM-YYYY)
Have you lived anywhere other than this address since the age of sixteen?
Yes No
If "Yes", Please provide the following information on all addresses youlived at since turning sixteen. Begin with your address immediatelybefore your current address.
Street Address (Line 1)
Street Address (Line 2) *Optional
City
State/Province
Postal Zone/ZIP Code
Country
Does Not Apply
Does Not Apply
To Date
Add Another
Previous AddressesHelp: Previous AddressesPrevious Addresses should onlyinclude those addresses at which youestablished a residence (for exampleon campus housing where you livedfor an academic term at your collegeor university) and should not includeplaces at which you were temporarilypresent (for example a hotel at whichyou stayed for vacation).
(format: MMM-YYYY)
(format: MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Present and Previous Address Information (continued)Phone
Primary Phone Number
Secondary Phone NumberDoes Not Apply
Work Phone NumberDoes Not Apply
E-Mail AddressE-Mail Address
(Enter in this format: xxx-xxx-xxxx)
Help: EmailYou must provide an email address.The email address you provide willbe used for correspondencepurposes. Provide and email addressthat is secure and to which you havereasonable access.
(e.g. [email protected])
PAGE 4
Help: PhoneYou must provide a primary phonenumber. The primary phone numbershould be the phone number at whichyou are most likely to be reached;this could be a land line or acellular/mobile number. If you havean additional land line or acellular/mobile number please listthat as your secondary phonenumber.
Have you used any other telephone numbers during the last five years?
Yes No
Add Another
If "Yes", Please provide the following information:
Additional Phone Number
Have you used any other email addresses during the last five years?
Yes No
Add Another
If "Yes", Please provide the following information:
Email Address
(e.g. [email protected])
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Present and Previous Address Information (continued)Social Media
Select from the list below each social media platform you have used within the lastfive years. In the space next to the platform’s name, enter the username or handleyou have used on that platform. Please do not provide your passwords. If youhave used more than one platform or more than one username or handle on asingle platform, click the ‘Add Another’ button to list each one separately. If youhave not used any of the listed social media platforms in the last five years, select‘None.’
Help: Social MediaEnter information associated withyour online presence, including thetypes of online providers/platforms,applications, and websites that youuse to collaborate, share information,and interact with others. List theusername, handle, screenname, orother identifiers associated with yoursocial media profile. You do not needto list accounts designed for use bymultiple users within a business orother organization.
Other Social Media
Do you wish to provide information about your presence on any other websitesor applications you have used within the last five years to create or sharecontent (photos, videos, status updates, etc.)?
Yes No
Social Media Provider/Platform 1
Social Media Identifier 1
Other Social Media Provider/Platform
Other Social Media Identifier
Add Another
If "Yes", Please provide the name of the platform and the associatedunique social media identifier (username or handle) for each socialmedia platform you would like to list. This does not include privatemessaging on person-to-person messaging services, such asWhatsApp.
Social Media Provider/Platform 2
Social Media Identifier 2
Social Media Provider/Platform 3
Social Media Identifier 3
Add Another
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Mailing and Permanent Address InformationMailing Address
Is your Mailing Address the same as your Present Address?
Yes No
If "No", Provide the following information:
Street Address (Line 2) *Optional
City
State/Province
Postal Zone/ZIP Code
Country/Region
Does Not Apply
Does Not Apply
Street Address (Line 1)
Help: Mailing AddressThis is the address where we willsend correspondence regarding yourapplication.
Permanent AddressPlease Provide the following information on where you intend tolive after arrival in the United States.
U.S. Street Address (Line 2) *Optional
City
State/Province
ZIP Code
Phone Number
U.S. Street Address (Line 1)
Name of person currently living at address
Does Not Apply
(e.g. 555-555-5555)Does Not Apply
PAGE 5
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Mailing and Permanent Address Information (continued)Is this the address where you want your Permanent Residence Card (Green Card)mailed?
Yes No
If "No", Please provide the address in the United States where youwant your Permanent Residence Card (Green card) mailed.
U.S. Street Address (Line 2) *Optional
City
State/Province
ZIP Code
Phone Number
U.S. Street Address (Line 1)
Contact Person
(e.g. 555-555-5555)Does Not Apply
PAGE 6
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Place of Birth
Family Information: Parents
Surnames
Given Names
Do Not Know
Father
Date of Birth
Is your father still living?Yes No
Do Not Know
Do Not Know
PAGE 7
NOTE: Please provide the followinginformation concerning yourbiological parents. If you areadopted, please provide the followingon your adoptive parents.
City
Do Not KnowState/Province
Do Not KnowCountry/Region
Do Not Know
If "No", please provide the following information:Year of Death
If "Yes", please provide the following information:Current Address
Street Address (Line 1)
Street Address (Line 2) * Optional
Country/Region
Do Not Know
City
State/ProvinceDoes Not Apply
Postal Zone/ZIP CodeDoes Not Apply
Residence Address Address Abroad
(format: DD-MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Family Information: Parents (continued)
Surnames at Birth
Given Names
Do Not Know
Mother
Date of Birth
Do Not Know
Do Not Know
Is your mother still living?Yes No
Place of BirthCity
Do Not KnowState/Province
Do Not KnowCountry/Region
Do Not Know
If "No", please provide the following information:Year of Death
If "Yes", please provide the following information:
If "No" or Father is no longer living,enter Current Address
Street Address (Line 1)
Street Address (Line 2) * Optional
Do Not Know
City
Country/Region
State/ProvinceDoes Not Apply
Postal Zone/ZIP CodeDoes Not Apply
Is your mother's address the same as your father's (if father stillliving?
Yes No
Residence Address Address Abroad
PAGE 8
(format: DD-MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
City
Country/Region
Family Information: Spouse
Surnames
Given Names
Date of Birth
Current Spouse
Place of Birth
Spouse's Address
If "OTHER", Provide your Spouse's Address (P.O. box numbers arenot allowed:
Street Address (Line 2)
City
State/Province
Postal Zone/ZIP Code
Country
Does Not Apply
Does Not Apply
Street Address (Line 1)
NOTE: Enter current spouseinformation. If divorced, enterprevious spouse information.
Mailing AddressUS ResidenceAbroad Address
PAGE 9
State/Province of BirthDo Not Know
Does Not Apply
(format: DD-MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Family Information: Spouse (continued)
City
State/Province
CountryDoes Not Apply
Date of Marriage
Date and Place of Marriage
Occupation
If "OTHER" or "NOT EMPLOYED", Provide the followinginformation:
Explain
Is your spouse immigrating to the U.S. with you?
Yes No
If "No", Is your spouse immigrating to the U.S. at a later date tojoin you?
Yes No
PAGE 10
(format: DD-MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Family Information: Previous Spouse
Do you have any previous spouses?
Yes No
Country/Region where marriage was terminated
Date of Birth
Provide the following information:
If "Yes", provide the following:
Number of Previous Spouses:
Surnames
Given Names
Date of Marriage
Date Marriage Ended
How was your marriage terminated?
If "OTHER", Provide the following information:
Explain Other
PAGE 11
(format: DD-MMM-YYYY)
(format: DD-MMM-YYYY)
(format: DD-MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Family Information: Children
Do you have any children?
Yes No
If Yes, Provide the following information:
Given Names
Date of Birth
Place of Birth
Country/Region
Surnames
State/ProvinceDoes Not Apply
PAGE 12
Help: Children InformationThe Immigration and Nationality Act(INA) does not allow derivative statusfor family members of immediaterelatives. IR1, CR1, IR2, CR2 andIR5 classifications are immediaterelative visa categories. If you havequestions about whether or not yourchild is allowed to immigrate to theU.S. with you or is allowed to followto join in the U.S., please seetravel.state.gov for more information.
Number of Children:
Provide the following information on each of your children (thisincludes all natural children, adopted children, and step children).
Child 1
City
Do Not Know
Does the child live with you?Yes No
Is this child immigrating to the U.S. with you?Yes No
If "No", Is this child immigrating to the U.S. at a later date tojoin you?
Yes No
If "NO", provide the AddressDo Not Know
Street Address (Line 1)
Street Address (Line 2) * Optional
City
Postal Zone/ZIP Code
Country/Region
Does Not Apply
Does Not ApplyState/Province
Residence Address Address Abroad
(format: DD-MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Previous U.S. Travel Information NOTE: Provide the followingprevious U.S. travel information.Provide complete and accurateinformation to all questions thatrequire an explanation.
Help: Previous U.S. VisitsIf you are unsure about when youvisited the U.S., please provide abest estimate.
Have you ever been in the U.S.?
Yes No
If "Yes", Provide the following information:
Were you issued an Alien Registration Number by theDepartment of Homeland Security?
Yes No
If "Yes", Provide the following information:
Alien Registration NumberDo Not Know
PAGE 13
Length of Stay
Date Arrived
Provide information on your last five U.S. visits:
Date Arrived
Length of Stay
Date Arrived
Length of Stay
Date Arrived
Length of Stay
Date Arrived
Length of Stay
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Have you ever been refused a U.S. Visa, been refused admission tothe United States, or withdrawn your application for admission atthe point of entry?
Previous U.S. Travel Information (continued)
NoYes
If "Yes", Explain:
If "Yes", provide the following information on your last U.S. visa:
Date Visa Was Issued
Visa Number
Has any of your U.S. visas ever been lost or stolen?
Has any of your U.S. visas ever been cancelledor revoked?
If "Yes", please explain:
Do Not Know
Yes No
Yes No
If "Yes", enter year visa was lost or stolen:
Q:
Q:
Visa Classification
Do Not Know
Explain
Have you ever been issued a U.S. Visa?Yes No
PAGE 14
(format: DD-MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Present Work/Education/Training Information
NOTE: Provide the followinginformation concerning your currentemployment or education.
Primary Occupation
Present Employer or School Name
Present employer or school address:
Street Address (Line 2) *Optional
City
State/Province
Postal Zone/ZIP Code
Country
Does Not Apply
Does Not Apply
Street Address (Line 1)
PAGE 15
Provide the following information for any occupation other than:"HOMEMAKER", "NOT EMPLOYED", and "RETIRED"
If primary occupation is "OTHER":
Specify Other
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Present Work/Education/Training Information (continued)
In which occupation do you intend to work in the U.S.?
Do you have other occupations? (Skip if current occupation is"NOT EMPLOYED")
Yes No
Other Occupation
Other Employer or School Name
Other employer or school address:
Street Address (Line 2) *Optional
City
State/Province
Postal Zone/ZIP Code
Country
Does Not Apply
Does Not Apply
Street Address (Line 1)
If "Yes", Provide the following information:
If occupation is "OTHER":
Specify Other
Provide the following information for any occupation other than:"HOMEMAKER" and "RETIRED"
If occupation is "OTHER", provide the following information:Specify Other
PAGE 16
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Previous Work/Education/Training Information
Were you previously employed?Yes No
If Yes, Provide the following information on all of your
Employer Name
Employer Street Address (Line 2) *Optional
City
State/Province
Postal Zone/ZIP Code
Country/Region
Does Not Apply
Does Not Apply
Employer Street Address (Line 1)
Telephone Number
Supervisor's Surname
Supervisor's Given Names
Employment Date From
Job Title
Employment Date To
(Enter in this format: xxx-xxx-xxxx)
PAGE 17
Do Not Know
Do Not Know
(format: DD-MMM-YYYY)
(format: DD-MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Date of Attendance To
Previous Work/Education/Training Information (Continued)
Help: Course of StudyFor high school course of studyplease indicate "Academic" or"Vocational." For all othereducational levels please indicateyour major or concentration.
Have you attended any educational institutions at a secondarylevel or above?
Yes No
Provide the following information on all educational institutions at asecondary level or above you have attended.
Name of Institution
Street Address (Line 2) *Optional
City
State/Province
Postal Zone/ZIP Code
Country/Region
Does Not Apply
Does Not Apply
Street Address (Line 1)
Course of Study
Date of Attendance From
PAGE 18
Help: Level of EducationYou must answer yes to thisquestion. If you have ever attendedhigh school, college, university,graduate school, doctoral program,or a vocational program.If "Yes", provide the following information:
Number of Educational Institutions Attended:
Degree, Diploma or Certificate Received
(format: DD-MMM-YYYY)
(format: DD-MMM-YYYY)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Additional Work/Education/Training Information
NOTE: Provide the following work,education, or training relatedinformation. Provide complete andaccurate information to all questionsthat require an explanation.
Have you belonged to, contributed to, or worked for any professional,social, or charitable organization?
Yes No
Have you ever served in the military?Yes No
If yes, Provide a List of Organizations:
Name of Country
Branch of Service
Date of Service ToDate of Service From
Rank/Position
Military Specialty
If "Yes", provide the following information:
PAGE 19
Specify Location (ONLY if Name of Country is "IRAQ")
Have you traveled to any countries/regions within the last fiveyears?
Yes No
Country/Region
If "Yes", Provide a List of Countries/Regions Visited:
Organization Name
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Do you have any specialized skills or training, such as firearms,explosives, nuclear, biological, or chemical experience?
Yes No
Have you ever served in, been a member of, or been involvedwith a paramilitary unit, vigilante unit, rebel group, guerrillagroup, or insurgent organization?
Yes No
If yes, Explain Skills or Training:
If yes, Explain:
Can you speak and/or read languages other than your nativelanguages?
Yes NoIf yes, list the languages that you speak and/or read:
Additional Work/Education/Training Information (Continued)
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Petitioner InformationPetitioner is my
Petitioner/Organization Name
Provide the following information for any type of Petitioner other than"SELF":
Petitioner
Street Address (Line 2) *Optional
City
State/Province
Postal Zone/ZIP Code
Country/Region
Does Not Apply
Does Not Apply
Street Address (Line 1)
Address and Phone Number of Petitioner
Telephone
Mobile/Cell TelephoneDoes Not Apply
Email AddressDoes Not Apply
(Enter in this format: xxx-xxx-xxxx)
(Enter in this format: xxx-xxx-xxxx)
(e.g. [email protected])
Help: PetitionerYour petitioner is generally the U.S.person or business who made aformal request that you beconsidered for an immigrant visa orpermanent legal residence. Yourpetitioner is generally your U.S.citizen relative, your U.S. permanentresident relative, or your U.S.employer. In some cases you mayhave filed a petition on your ownbehalf.
Help: Email AddressThe email address you provide forthe petitioner may be used forcorrespondence purposes. Pleaseprovide an email address that issecure and to which your petitionerhas reasonable access.
Individual Residence Address Individual Address Abroad
PAGE 20
Individual Employer
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Security and Background: Medical and Health Information
NOTE: Provide the following securityand background information. Providecomplete and accurate information toall questions that require anexplanation. A visa may not beissued to persons who are withinspecific categories defined by law asinadmissible to the United States(except when a waiver is obtained inadvance). Are any of the followingapplicable to you? A YES answerdoes not automatically signifyineligibility for a visa. Please notethat should you answer Yes to anyof the following questions, youmay be requested to providedocumentation to support yourexplanation.
Do you have a communicable disease of public healthsignificance such as tuberculosis (TB)?
Yes No
Do you have a mental or physical disorder that poses or is likelyto pose a threat to the safety or welfare of yourself or others?
Yes No
Are you or have you ever been a drug abuser or addict?Yes No
If yes, Explain:
If yes, Explain:
If yes, Explain:
PAGE 21
Do you have documentation to establish that you have receivedvaccinations in accordance with U.S. law?
Yes NoIf no, Explain:
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Security and Background: Criminal Information
Have you ever been arrested or convicted for any offense orcrime, even though subject of a pardon, amnesty, or other similaraction?
Yes No
Have you ever violated, or engaged in a conspiracy to violate,any law relating to controlled substances?
Yes No
Are you coming to the United States to engage in prostitution orunlawful commercialized vice or have you been engaged inprostitution or procuring prostitutes within the past 10 years?
Yes No
Have you ever been involved in, or do you seek to engage in,money laundering?
Yes No
If yes, Explain:
If yes, Explain:
If yes, Explain:
If yes, Explain:
PAGE 22
NOTE: Provide the following securityand background information. Providecomplete and accurate information toall questions that require anexplanation. A visa may not beissued to persons who are withinspecific categories defined by law asinadmissible to the United States(except when a waiver is obtained inadvance). Are any of the followingapplicable to you? A YES answerdoes not automatically signifyineligibility for a visa. Please notethat should you answer Yes to anyof the following questions, youmay be requested to providedocumentation to support yourexplanation.
Are you the spouse, son, or daughter of an individual who has violatedany controlled substance trafficking law, and have knowlingly benefitedfrom the trafficking activities in the past five years?
Yes NoIf yes, Explain:
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Security and Background: Criminal Information (continued)
Have you ever committed or conspired to commit a humantrafficking offense in the United States or outside the UnitedStates?
Yes NoIf yes, Explain:
Have you ever knowingly aided, abetted, assisted, or colluded with an individualwho has been identified by the President of the United States as a person whoplays a significant role in a severe form of trafficking in persons?
Yes NoIf yes, Explain:
Are you the spouse, son, or daughter of an individual who has committed orconspired to commit a human trafficking offense in the United States or outside theUnited States and have you within the last five years, knowingly benefited fromthe trafficking activities?
Yes NoIf yes, Explain:
PAGE 23
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Security and Background: Security Information 1
Do you seek to engage in espionage, sabotage, export controlviolations, or any other illegal activity while in the United States?
Yes No
Do you seek to engage in terrorist activities while in the UnitedStates or have you ever engaged in terrorist activities?
Yes No
Have you ever or do you intend to provide financial assistance orother support to terrorists or terrorist organizations?
Yes No
Are you a member or representative of a terrorist organization?Yes No
Have you ever ordered, incited, committed, assisted, or otherwiseparticipated in genocide?
Yes No
Have you ever committed, ordered, incited, assisted, or otherwise participated intorture?
Yes No
Have you committed, ordered, incited, assisted, or otherwise participated inextrajudicial killings, political killings, or other acts of violence?
Yes No
Have you, while serving as a government official, been responsible for or directlycarried out, at any time, particularly severe violations of religious freedom?
Yes No
If yes, Explain:
If yes, Explain:
If yes, Explain:
If yes, Explain:
If yes, Explain:
If yes, Explain:
If yes, Explain:
If yes, Explain:
PAGE 24
NOTE: Provide the following securityand background information. Providecomplete and accurate information toall questions that require anexplanation. A visa may not beissued to persons who are withinspecific categories defined by law asinadmissible to the United States(except when a waiver is obtained inadvance). Are any of the followingapplicable to you? A YES answerdoes not automatically signifyineligibility for a visa. Please notethat should you answer Yes to anyof the following questions, youmay be requested to providedocumentation to support yourexplanation.
Have you ever engaged in the recruitment of or the use of child soldiers?Yes No If yes, Explain:
Help: Terrorist organizationsTerrorist organizations include, butare not limited to groups listed .here
Are you the spouse, son, or daughter of an individual who has engaged in terroristactivity, including providing financial assistance or other support to terrorists orterrorist organizations, in the last five years?
Yes No If yes, Explain:
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Security and Background: Security Information 2
Are you a member of or affiliated with the Communist or othertotalitarian party?
Yes No If yes, Explain:
Have you ever directly or indirectly assisted or supported any of the groups inColombia known as the Revolutionary Armed Forces of Colombia (FARC),National Liberation Army (ELN), or United Self-Defense Forces of Columbia(AUC)?
Yes No If yes, Explain:
NOTE: Provide the following securityand background information. Providecomplete and accurate information toall questions that require anexplanation. A visa may not beissued to persons who are withinspecific categories defined by law asinadmissible to the United States(except when a waiver is obtained inadvance). Are any of the followingapplicable to you? A YES answerdoes not automatically signifyineligibility for a visa. Please notethat should you answer Yes to anyof the following questions, youmay be requested to providedocumentation to support yourexplanation.
Have you ever, through abuse of governmental or political position convertedfor personal gain, confiscated or expropriated property in a foreign nation towhich a United States national had claim of ownership?
Yes No If yes, Explain:
Are you the spouse, minor child, or agent of an individual who has throughabuse of governmental or political position converted for personal gain,confiscated or expropriated property in a foreign nation to which a UnitedStates national had claim of ownership?
Yes No If yes, Explain:
Have you ever been directly involved in the establishment or enforcement ofpopulation controls forcing a woman to undergo an abortion against her freechoice or a man or a woman to undergo sterilization against his or her freechoice?
Yes No If yes, Explain:
Have you ever disclosed or trafficked in condifential U.S. business informationobtained in connection with U.S. participation in the Chermical WeaponsConvention?
Yes No If yes, Explain:
Are you the spouse, minor child, or agent of an individual who has disclosedor trafficked in confidential U.S. business information obtained in connectionwith U.S. participation in the Chemical Weapons Convention?
Yes No If yes, Explain:
PAGE 25
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Security and Background: Immigration Law ViolationsInformation 1
Have you ever been the subject of a removal or deportationhearing?
Yes No
Have you ever sought to obtain or assist others to obtain a visa,entry into the United States, or any other United Statesimmigration benefit by fraud or willful misrepresentation or otherunlawful means?
Yes No
Have you failed to attend a hearing on removability or inadmissibilitywithin the last five years?
Yes No
Have you ever been unlawfully present, overstayed the amount oftime granted by an immigration official or otherwise violated theterms of a U.S. visa?
Yes No
If yes, Explain:
If yes, Explain:
If yes, Explain:
If yes, Explain:
PAGE 26
NOTE: Provide the following securityand background information. Providecomplete and accurate information toall questions that require anexplanation. A visa may not beissued to persons who are withinspecific categories defined by law asinadmissible to the United States(except when a waiver is obtained inadvance). Are any of the followingapplicable to you? A YES answerdoes not automatically signifyineligibility for a visa. Please notethat should you answer Yes to anyof the following questions, youmay be requested to providedocumentation to support yourexplanation.
Are you subject to a civil penalty under INA 274C?
Yes No If yes, Explain:
Have you been ordered removed from the U.S. during the last five years?
Yes No If yes, Explain:
Have you been ordered removed from the U.S. for a second time within thelast 20 years?
Yes NoIf yes, Explain:
Have you ever been removed or deported from any country?Yes No If yes, Explain:
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Security and Background: Immigration Law ViolationsInformation 2
Have you ever been convicted of an aggravated felony and beenordered removed from the U.S.?
Yes No
Have you ever been unlawfully present and ordered removedfrom the U.S. during the last ten years?
Yes No
If yes, Explain:
If yes, Explain:
Have you ever been unlawfully present in the U.S. for more than180 days (but no more than one year) and have voluntarilydeparted the U.S. within the last three years?
Yes No If yes, Explain:
Have you ever been unlawfully present in the U.S. for more thanone year or more than one year in the aggregate at any timeduring the last 10 years?
Yes No If yes, Explain:
NOTE: Provide the following securityand background information. Providecomplete and accurate information toall questions that require anexplanation. A visa may not beissued to persons who are withinspecific categories defined by law asinadmissible to the United States(except when a waiver is obtained inadvance). Are any of the followingapplicable to you? A YES answerdoes not automatically signifyineligibility for a visa. Please notethat should you answer Yes to anyof the following questions, youmay be requested to providedocumentation to support yourexplanation.
PAGE 27
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Security and Background: Miscellaneous Information 1
Have you ever withheld custody of a U.S. citizen child outsidethe United States from a person granted legal custody by a U.S.court?
Yes No
Have you ever intentionally assisted another person in withholding custody of aU.S. citizen child outside the United States from a person granted legla custodyby a U.S. court?
Yes No
Have you voted in the United States in violation of any law orregulation?
Yes No
Have you ever renounced United States citizenship for thepurpose of avoiding taxation?
Yes No If yes, Explain:
If yes, Explain:
If yes, Explain:
If yes, Explain:
PAGE 28
NOTE: Provide the following securityand background information. Providecomplete and accurate information toall questions that require anexplanation. A visa may not beissued to persons who are withinspecific categories defined by law asinadmissible to the United States(except when a waiver is obtained inadvance). Are any of the followingapplicable to you? A YES answerdoes not automatically signifyineligibility for a visa. Please notethat should you answer Yes to anyof the following questions, youmay be requested to providedocumentation to support yourexplanation.
Have you attended a public elementary schol or a publicsecondary school on student (F) status after November 30, 1996without reimbursing the school?
Yes No If yes, Explain:
Do you seek to enter the United States for the purpose ofperforming skilled or unskilled labor but have not yet beencertified by the Secretary of Labor?
Yes No If yes, Explain:
Are you a gradute of a foreing medical school seeking to perform medicalsrvices in the United States but have not yet passed the National Board ofMecial Examiners examination or its equivalent?
Yes No If yes, Explain:
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Security and Background: Miscellaneous Information 2
Are you a health care worker seeking to perform such work in the UnitedStates but have not yet received certification from the Commission onGraduates of Foreign Nursing Schools or from an equivalent approvedindependent credentialing organization?
Yes No If yes, Explain:
NOTE: Provide the following securityand background information. Providecomplete and accurate information toall questions that require anexplanation. A visa may not beissued to persons who are withinspecific categories defined by law asinadmissible to the United States(except when a waiver is obtained inadvance). Are any of the followingapplicable to you? A YES answerdoes not automatically signifyineligibility for a visa. Please notethat should you answer Yes to anyof the following questions, youmay be requested to providedocumentation to support yourexplanation.
Are you permanently ineligible for U.S. citizenship?Yes No If yes, Explain:
Have you ever departed the United States in order to evade militaryservice during a time of war?
Yes No If yes, Explain:
Are you coming to the U.S. to practice polygamy?
Yes No If yes, Explain:
Are you a former exchange visitor (J) who has not yet fulfilled thetwo-year foreign residence requirement?
Yes No If yes, Explain:
Has the Secretary of Homeland Security of the United States everdetermined that you knowingly made a frivolous application for asylum?
Yes No If yes, Explain:
Are you likely to become a public charge after you are admitted to theUnited States?
Yes No If yes, Explain:
PAGE 29
DS-260 - Immigrant Visa and Alien Registration Application
Form Property of Cerenade.© Cerenade. All Rights Reserved.
DS-260 [Rev. June 19, 2020]
Have you ever applied for a Social Security number?
Were you issued a number?
If "Yes", provide the following information:
Social Security Number Information
Yes No
Do you want the Social Security Administration to issue a SocialSecurity number and a card?
Yes No
Help: Social Security NumberA Social Security Number is anine-digit number issued to U.S.citizens, permanent residents, andtemporary residents present in theU.S. for the purpose of employmentand is issued by the Social SecurityAdministration.
Do you authorize disclosure of information from this form to the Department ofHomeland Security, the Social Security Administration, and such other U.S.Government agencies as may be required for the purposes of assigning you asocial security number (SSN) and issuing you a Social Security card and do youauthorize the Social Security Administration to share your SSN with theDepartment of Homeland Security?
Yes No
Help: Social Security Card IssuancePlease note that you must answerYes to the Consent to Disclosequestion that follows in order for aSocial Security Number and card tobe issued.
Help: Consent to DisclosureThe applicant's response does notlimit or restrict the Government'sability to obtain his or her socialsecurity number or other informationon this form for enforcement or otherpurposes as authorized by law.
Yes No
If "Yes", provide the following information:Social Security Number
Do Not Know
Do you need a new card issued?Yes No
If "No", provide the following information:
Help: Social Security Number IssuedIf you do not know the SocialSecurity number, click on
PAGE 30
If you answer 'No' to this question you will not receive a socialsecurity card.
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