application

date of birth

place of birth

permanent address

signature

maiden name

criminal record

to issue

What is your name?

Have you ever used another name?

What is the name of your spouse (female)?

What do you do for living?

Where were your parents born?

Please give me the information of your emergency contact person.

What are your parents’ dates of birth?

What is your mother's maiden name?

If you have an ID number, what is it?

What is your permanent address?

What is your address?

What is your civil status?

Have you ever been married?

Do you have a criminal record?

Is this your signature?

Is this you in the photo?

When and where did you submit this application?

Where did you have the application notarized?

What was the notary’s name?

What are your travel plans?

Have you ever had a U.S. visa?

Have you ever been to the United States?

Is there anything else you want to add?