美国移民DS260表全文(English).docxVIP

Personal Information 1 OMB CONTROL NUMBER: 1405-0185 FORM NUMBER: DS-260 EXPIRATION DATE: 01/31/2016 ESTIMATED BURDEN: 120 MIN NOTE: Data on this page must match the information as it is written in your passport or travel documents. Surnames  Given Names Full Name in Native Alphabet Have you ever used other names (i.e., maiden, religious, professional, alias, etc.)? （yes）(no) Sex (male) female) Current Marital Status Date of Birth (Format: DD-MMM-YYYY) City of Birth State/Province of Birth Country/Region of Birth Personal Information 2 Country/Region of Origin (Nationality) Document Type Document ID Country/Authority that Issued Document Issuance Date (Format: DD-MMM-YYYY) Expiration Date (Format: DD-MMM-YYYY) Do you hold or have you held any nationality other than the one you have indicated above? (yes)(no) Present Address Street Address (Line 1) Street Address (Line 2) *Optional  City State/Province Postal Zone/ZIP Code Country/Region Started Living Here (Format: MMM-YYYY) Previous Addresses Have you lived anywhere other than this address since the age of sixteen? (Date you turned sixteen: 23-Mar-2001) (yes) (no) Street Address (Line 1) Street Address (Line 2) *Optional City State/Province Postal Zone/ZIP Code Country/Region Started Living Here (Format: MMM-YYYY) To Date (Format: MMM-YYYY) Phone Primary Phone Number Secondary Phone Number Work Phone Number Email Email Address Mailing and Permanent Address Information Is your Mailing Address the same as your Present Address? (yes) (no) Permanent Address Please provide the following information on where you intend to live after arrival in the United States. Name of person currently living at address U.S. Street Address (Line 1) U.S. Street Address (Line 2) *Optional  City State ZIP Code Phone Number Is this address where you want your Permanent Residence Card (Green Card) mailed? (yes) (no) Family Information: Parents Father Surnames Given Names Date of Birth (Format: DD-MMM-YYYY) Place of Birth Ci