Fillable Printable Form DS-157
Fillable Printable Form DS-157
Form DS-157
Address
Address
Branch of Service
16. Have you ever been in an armed conflict, either as a participant or victim?
Dates of Service
(mm-dd-yyyy) or "Present"
From To
Name of Country Rank/Position Military Specialty
Dates of Employment
(mm-dd-yyyy) or "Present"
From To
Name Telephone Number Job Title Supervisor's Name
14. Do you have any specialized skills or training, including firearms,
explosives, nuclear, biological, or chemical experience?
13. List all professional, social and charitable organizations to wh ich you belong
(belonged) or contribute (contributed) or with which you work (have worked).
10. List all countries that have ever issued you a passport.9. List all countries you have entered in the last ten years.
(Give the year of each visit)
8. Full Name and Address of Contact Person or Organization in the United States (Include telephone number)
PLEASE TYPE OR PRINT YOUR ANSWERS IN THE SPACE PROVIDED BELOW EACH ITEM
PLEASE ATTACH AN ADDITIONAL SHEET IF YOU NEED MORE SPACE TO CONTINUE YOUR ANSWERS
17. List all educational institutions you attend or have attended. Include vocational institutions but not elementary schools.
12. Not including current employer, list your last two employers.
15. Have you ever performed military service?
DS-157
03-2015
1. Last Name(s) (List all spellings) 2. First Name(s) (List all spellings) 3. Full Name (In native alphabet)
If yes, complete below.
Yes
No
18. Have you made specific travel arrangements?
If YES, please provide a complete itinerary for your travel, including arrival/departure dates, flight information, specific location you will visit, and a point of contact
at each location.
Yes
No
4. Clan or Tribe Name (If applicable) 5. Spouse's Full Name (If married)
6. Father's Full Name 7. Mother's Full Name
11. Have you ever lost a passport
or had one stolen?
Yes
No
If YES, please explain.
Yes
No
Confidentiality Statement - INA Section 222(f) provides that visa issuance and refusal records shall be considered confidential and shall be used only for the formulation, amendment, administration, or
enforcement of the immigration, nationality, and other law s of the United States. Certif ied copi es of v isa recor ds ma y be made available to a court w hich certifi es that t he inf or mati on contai ned in such records is
needed in a case pending before the court.
Paperwork Reduction Act Statement - Public reporting burden for this collection of information is estimated to average 1 hour 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 informat ion unless this collec tion displ ays 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: PRA_BurdenComment[email protected]
If YES, please explain.
Yes
No
Dates of Attendance
(mm-dd-yyyy) or "Present"
From To
Name of Institution Telephone Number Course of Study
CONFIDENTI ALI TY AND PA PER WO RK REDUC TI O N ACT STATEMENTS
SUPPLEMENTAL NONIMMIGRANT VI SA APPLICATION
Approved OMB 1405-01 34
Expires 03/31/2018
Estimated Burden 1 Hour*
U.S. Department of State
