Visa Section Contact Form

Please Select Your Inquiry from the List Below:

Select the Service:

Nonimmigrant Visa
Immigrant Visa
Boarding Foil

Full Name:

(As it appears in passport)

To complete the DS-5535, click here (PDF 53 KB).

After completing the DS-5535, scan the three pages as one file and attach to an email to: Paris221gdocs@state.gov, for the Subject of the email, please use your: FAMILY NAME, First Name - DS-5535.

*Please note that sending your DS-5535 as separate files for each page will delay processing*

Surname(s)/Family Name(s)

Given Name(s)

Date of Birth:

Visa Type/Classification:

DS-160 Number (begins with AA):

All Prior Passport Information – Provide country of issuance and passport number:

File Number:

(Begins with PRS)

Interview Date:

Email Address:*

Telephone Number:

Brief explanation of your question:

Comment

Message:

Travel History – List all travel outside your country of residence over the last 15 years (for each trip, include locations visited, dates of travel, and source of funds for trip):

Siblings (brothers and sisters) – Provide the full name(s) and date of birth of any sibling (include full, half, step, adopted siblings), living or deceased:

Children – Provide the full name(s) and date of birth of any child (minor or adult), living or deceased. Children includes natural children, step-children, and adopted children (you do not need to include any children you have already included in your current visa application):

Spouse – Provide the full name(s) and date of birth of any current and previous spouse or civil/domestic partner, living or deceased:

Addresses – Provide all residential addresses during the last 15 years, including start and end dates of residence (if different from the current address you provided in your application):

Phone Numbers – Provide all phone numbers used in the last five years, including primary, secondary, work, home, and mobile numbers:

Email Addresses – Provide all email addresses you have used in the last five years, including primary, secondary, work, personal and educational email addresses:

Social Media – Provide your unique user name for any websites or applications you have used to create or share content (photos, videos, status updates, etc.) as part of a public profile within the last five years. You do not need to list accounts designed for use by multiple users within a business or other organization. List the Social Media Platform and your Social Media Identifier (name/handle/user ID):

Employment History – For the last 15 years, for each prior place of employment, provide the name of your employer, your dates of employment, the full address of your employment, a telephone number for your employer, your job title, and a description of your job:

Additional Documents to submit (e.g. court records, CV/resume, acte de naissance, etc.)

File

Accepted file types: pdf, jpg, doc, docx, jpeg, Max. file size: 2 MB.

File

Accepted file types: pdf, jpg, doc, docx, jpeg, Max. file size: 2 MB.

File

Accepted file types: pdf, jpg, doc, docx, jpeg, Max. file size: 2 MB.

Signature*

I understand all the information I have provided in, or in support of, this application may be provided to other U.S. government agencies authorized to use such information for purposes including enforcement of the laws of the United States. I understand all of the information contained in this form and I certify under penalty of perjury under the laws of the United States of America that the foregoing is complete, true, and correct. I understand that any willfully false or misleading statement or willful concealment of a material fact made by me herein may result in refusal of the visa, denial of admission to the United States, and, may subject me to criminal prosecution and/or removal from the United States.

Full Name(s)*

Today's Date:*

CONFIDENTIALITY STATEMENT

AUTHORITIES: The information on this form is requested pursuant to Section 212(a) and 221 and as required by Section 222 of the Immigration and Nationality Act. Section 222(f) provides that the records of the Department of State 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, in the discretion of the Secretary of State, 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.

PURPOSE: The U.S. Department of State uses the information provided on this form to determine an individual’s eligibility for a U.S. visa. Individuals who fail to submit this form or who do not provide all the requested information may be denied a U.S. visa. Although furnishing this information is voluntary, failure to provide this information may delay or prevent the processing of an individual visa application.

File

Accepted file types: pdf, doc, Max. file size: 5 MB.

File

Accepted file types: doc, pdf, Max. file size: 5 MB.

File

Accepted file types: doc, pdf, Max. file size: 5 MB.