在线填写-递交美国DS156表

1.护照号码
Passport Number

2.签发护照地点
Place of Issuance

   城市 City

   国家 Country

   州∕省份 State/Province

3.签发您护照的国家
Issuing Country

4.签照日期（日/月/年）
Issuance Date (dd-mm-yyyy)

日 day | 月 month | 年 year

5.失效日期（日/月/年）
Expiration Date (dd-mmh-yyyy)

日 day | 月 month | 年 year

6.姓（如护照所显示）
Surnames (As in Passport)

7.名（如护照所显示）
First and Middle Names (As in Passport)

8.其他姓氏（未婚时称呼/宗教称呼/工作用称呼/化名）－（没有请留空）
Other Surnames Used (Maiden, Religious, Professional, Aliases)

9.其他名字－（没有请留空）
Other First and Middle Names Used

10.出生日期（日/月/年）
Date of Birth (dd-mm-yyyy)

日 day | 月 month | 年 year

11.出生地
Place of Birth

   州∕省份 State/Province

   城市 City

   国家 Country

12.现国籍
Nationality

13.性别
Sex

男 Male
女 Female

14.身份证号码
National Identification Number

15.住址（国家邮编区号州∕省城市街道单元号码）
Home Address (Include apartment number, street, city, state or province, postal zone and country)

   街道名称1 Street Address Line 1

   街道名称2 Street Address Line 1

   城市 City

   州/省份 State/Province

   邮编区号 Postal Code

   国家 Country

16.联系方式（没有请填NONE）
Contact

住宅电话 Home Telephone Number	工作电话 Business Phone Number	移动电话 Mobile/Cell Number
传真 Fax Number	工作传真号码 Business Fax Number	传呼机号码(BP 机) Pager Number

17.婚姻状况
Marital Status

18.配偶姓名（离婚或分居，包括婚前姓氏）－（没有请留空）
Spouse's Full Name(Even if divorced or separated. Include maiden name.)

19.配偶出生日期（日/月/年）－（没有请留空）
Spouse's DOB (dd-mm-yyyy)

日 day | 月 month | 年 year

20.现任僱主或就读学校名称和地址
Name and Address of Present Employer or School

   名称 Name

   地址 Address

21.现任职业-若退休则输入"retired",学生则输入"student"
Present Occupation-(If retired, write & retired". If student, write "student".)

22.拟抵美时间（日/月/年)-（请提供日期）
When Do You Intend To Arrive In The U.S.(Provide specific date if known)

日 day | 月 month | 年 year

23.电子邮件地址
E-Mail Address

24.在美期间住址
At What Address Will You Stay in The U.S.

   街道名称 Street Address Line 1

   街道名称 Street Address Line 2

   城市 City

   省份/州 State/Province

   邮遍区号 Postal Code

25.您将在美逗留∕旅游探访∕公干的联系人的姓名及电话号码－（没有请填NONE）
Name and Telephone Numbers of Person in U.S. Who You Will Be Staying With or Visiting for Tourism or Business

姓名 Name	住宅电话 Home Phone
工作电话 Business Phone	移动电话 Cell Phone

26.拟在美逗留多久
How Long Do You Intend To Stay in The U.S.

27.此行目的
What is The Purpose of Your Trip

28.此行费用由谁负担
Who Will Pay For Your Trip

29.您是否到过美国
Have You Ever Been to U.S.A

    有 Yes 没有 No
   何时 When
   日 day | 月 month | 年 year

   逗留了多久 FOR HOW LONG

   其他赶美经历 Enter Additional Visits to the U.S. Here

30.您是否得到过美国的签证
Have You Ever Been Issued a U.S. Visa

    得到过 Yes 没有得到过 No
   何时 When
   日 day | 月 month | 年 year
    年
   在何地获得 Where

   签证类型 WHAT TYPE OF VISA

   其他签证经历 Enter Additional Visa Issuances Here

31.您是否有过被美国拒签的经历
Have You Ever Been Refused a U.S. Visa

    有 Yes 没有 No
   何时 When
   日 day | 月 month | 年 year

   在何地 Where

   签证类型 WHAT TYPE OF VISA

   其他被美国拒签经验 Enter Additional Visa Refusals Here

32.您是否有意在美国就业
Do You Intend To Work in The U.S.

    有意 Yes 无意 No
    （如有意就业﹐请注明美国僱主的名称及地址）
   (If YES, give the name and complete address of U.S. employer.)

33.您是否有意在美国就读
Do You Intend To Work in The U.S.

    有意 Yes 无意 No
   （如有意就读者﹐请注明美国学校的名称及地址）
   (If YES, give the name and complete address of the school.)

34.同行人姓名，与您的关系（没有请填NONE）
Names and Relationships of Persons Traveling With You

35.您的美国签证有否曾被吊销作废
Has Your U.S. Visa Ever Been Cancelled or Revoked

有过 Yes 没有 No

36.是否曾有人为您申办过移民签证
Has Anyone Ever Filed an Immigrant Visa Petition on Your Behalf

    有过 Yes 没有 No
   If Yes, Who?
   如“有”﹐是谁?

37.下列亲属中是否有人目前已在美国?他们是否是美国合法永久居民或美过公民?
   Has Your U.S. Visa Ever Been Cancelled or Revoked?Are Any of The Following Persons in The U.S., or Do They Have U.S. Legal Permanent Residence or U.S. Citizenship?
   请注明“在美国”/“不在美国”並证明其在美国的身份（即：是美国合法永久居民还是美过公民，是否正在美国访问/留學/工作等等）
   Mark YES or NO and indicate that person's status in the U.S. (i.e., U.S. legal permanent resident, U.S. citizen, visiting, studying, working, etc.).

38.请注意﹕每位申请人都必須通读並回答下列所有问题
IMPORTANT: ALL APPLICANTS MUST READ AND CHECK THE APPROPRIATE BOX FOR EACH ITEM.

1. 是否由于犯有任何罪刑而曾经被逮捕和被判有罪，即时后来得到了宽恕、赦免或受益于其他类似措施？是否曾非法分发或出售过受控物品(毒品)？是否曾从事卖淫活动或曾为卖淫者拉客？
   Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty or other similar legal action? Have you ever unlawfully distributed or sold a controlled substance(drug), or been a prostitute or procurer for prostitutes?
是 Yes 否 No

2. 是否曾经被美国拒绝入境或成为递解出境听证的对象？是否曾以欺骗或故意作假及其他手段歧途自己得到或帮助他人得到美国签证或任何其他移民福利、企图自己或帮助他人进入美国？是否曾在1996年11月30日以后以学生身份到美国公立小学或公立中学就读而未向学校补偿费用？
   Have you ever been refused admission to the U.S., or been the subject of a deportation hearing or sought to obtain or assist others to obtain a visa, entry into the U.S., or any other U.S. immigration benefit by fraud or willful misrepresentation or other unlawful means? Have you attended a U.S. public elementary school on student (F) status or a public secondary school after November 30, 1996 without reimbursing the school?
是 Yes 否 No

3. 是否希望进入美国？是否为了违反出口控制的活动、为了从事颠覆或恐怖主义活动？是否有其他非法目的？是否是目前被美国国务卿认定的恐怖主义组织的成员或代表？是否曾参加过德国纳粹政府指使下进行的迫害？是否参加过旨在种族灭绝的屠杀？
   Do you seek to enter the United States to engage in export control violations, subversive or terrorist activities, or any other unlawful purpose? Are you a member or representative of a terrorist organization as currently designated by the U.S. Secretary of State? Have you ever participated in persecutions directed by the Nazi government of Germany; or have you ever participated in genocide?
是 Yes 否 No

4. 是否曾违反过美国签证的有关规定？是否曾非法进入美国或者曾被美国递解出境？
   Have you ever violated the terms of a U.S. visa, or been unlawfully present in, or deported from, the United States?
是 Yes 否 No

5. 是否曾拒绝把身为美国公民但身处美国境外的子女的监护权移交给美国法庭享有监护权的人？是否曾违反法规在美国投票或为达道逃避税务的目的而放弃美国国籍？
   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, voted in the United States in violation of any law or regulation, or renounced U.S. citizenship for the purpose of avoiding taxat

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