QUESTIONNAIRE (Please answer all the questions in English and add additional pages when required.

Failure to provide complete information may result in lengthy delays in eventual visa issuance. `qv Ki cwZwU cki Di BsivRxZ

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1. List all international travel by country in the past 10 years. Please specify month and year. Avcwb MZ `k eQi

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2. List all passports that you now hold or have previously held . Please include passport number, issue date, expiration date and place of issue. If you have ever had a passport lost or stolen, please indicate that as well. Avcbvi GLb h

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3. List all educational institutions you have attended. Please specify month and year. Avcwb h mKj wkv

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4. List all occupations you have held. Please specify month and year. If you own a business organization, please list that also. (Please Note: Private Service, Government Service, and Business are not acceptable answers. More details are required.) Avcwb hmKj c`/ ckvq KvR KiQb mejvi Z_ w`b| Avcwb wbR hw` Kvb cwZvbi gvwjK nb Ze ZvI DjL Kib| gvm Ges eQi DjL Kib| gb ivLeb, Private Service, Government Service, and Business MnYhvM Di bq, wevwiZ weeiY `iKvi| 5. List all political, social and charitable organizations to which you have ever belonged. Indicate how long you have been a member of each organization. Avcwb hw` KLbI Kvb ivRbwZK, mvgvwRK Ges `vZe cwZvbi m

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7. List all previous residences. Please give full address, specify month and year. By residence we mean, any location that you ever lived since birth. Avcwb h mKj RvqMvq c~e emevm KiwQjb, Zvi cwic~Y weeiY w`b| `qv Ki cwZwU vbi c~Y wVKvbv Ges gvm I eQi DjL Kib| Residence ejZ Avcwb Rb _K

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8. Have you ever applied for immigration or citizenship of any country? If so, which country? Date of request? Status of application? Avcwb wK Ab Kvb `ki Awfevmb (BwgMkb) ev bvMwiKZi Rb Ave`b KiQb? Di

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9. Height and weight. Avcbvi DPZv Ges IRb wjLzb| 10. List the names and dates of birth of your parents and all of your children, siblings (brothers/sisters). Avcbvi evev-gv

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(For Non-Immigrant Visa Applicants) (For Immigrant Visa Applicants)

Name of Applicant:_____________________

Name of Applicant:_____________________

Passport Number:_______________________ Case Number:_________________________