26/07/2025, 00:58 Consular Electronic Application Center - Print Application
Online Nonimmigrant Visa Application (DS-160)
Application - Sensitive But Unclassified(SBU)
We do not need a printed copy of your application at any point during your interview process. Only print this
application if you want a copy for your own records. If you print your application, please keep it secure.
Photo Provided:
Confirmation Number:
Your Personal Copy -- Do Not Bring to Interview
Personal, Address, Phone, and Passport/Travel Document Information
Name Provided: SARASWATI, SHREYANSH
Full Name in Native Language: SHREYANSH SARASWATI
Other Names Used: NO
Telecode Name Used: NO
Sex: MALE
Marital Status: SINGLE
Date of Birth: 06 SEPTEMBER 2010
Place of Birth: MOTIHARI, BIHAR, INDIA
Country/Region of Origin (Nationality): INDIA
Do you hold or have you held any nationality other than the one NO
indicated above on nationality?
Are you a permanent resident of a country/region other than your NO
country/region of origin (nationality) above?
National Identification Number: 4355 9012 2608
U.S. Social Security Number: DOES NOT APPLY
U.S. Taxpayer ID Number: DOES NOT APPLY
Home Address: RADIOLOGY INSTITUTE , NEAR COLD STORAGE
BHAWANIPUR ZIRAT
City: MOTIHARI
State/Province: BIHAR
Postal Zone/ZIP Code: 845401
Country/Region: INDIA
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Same Mailing Address? YES
Primary Phone Number: 9308507967
Secondary Phone Number: DOES NOT APPLY
Work Phone Number: DOES NOT APPLY
Do you have any additional phone numbers? NO
Do you have any additional email addresses? NO
Do you have a social media presence?
Social Media Platform: (1): Instagram
Social Media Identifier: @SHREYANSHSARASWATI007
Do you have any additional social media presence? NO
Passport/Travel Document Type: REGULAR
Passport/Travel Document Number: I0520081
Passport Book Number: DOES NOT APPLY
Country/Authority that Issued Passport/Travel Document: INDIA
City Where Issued: PATNA
State/Province Where Issued: BIHAR
Country/Region Where Issued: INDIA
Issuance Date: 07 MAY 2025
Expiration Date: 05 SEPTEMBER 2028
Have you ever lost a passport or had one stolen? NO
Travel Information
The List of Purposes of Trip to the U.S.
Purpose of Trip to the U.S. (1): TEMP. BUSINESS OR PLEASURE VISITOR (B)
Specify: TOURISM/MEDICAL TREATMENT (B2)
Have you made specific travel plans? YES
Provide a complete itinerary for your travel to the U.S.:
Date of Arrival in U.S.: 15 MAY 2026
Arrival City: LOS ANGELES
Date of Departure from U.S.: 25 MAY 2026
Address where you will stay in the U.S.: DAYS INN & SUITES BY WYNDHAM
1111 S HARBOR BLVD
City, State, Postal/Zip Code: ANAHEIM, CALIFORNIA 92805
Person/Entity Paying for Your Trip: OTHER PERSON
Person Paying for Your Trip: KUMAR , AMARESH
Telephone Number: 8809766818
Relationship to You: PARENT
Is the address of the party paying for your trip the same as your Home YES
or Mailing Address?
Are there other persons traveling with you? YES
Are you traveling as part of a group or organization? NO
Persons Traveling with You:
Name (1): SARASWATI, ANSHIKA
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Relationship to You: OTHER
Name (2): KUMAR, AMARESH
Relationship to You: PARENT
Name (3): SHRIVASTAVA, NISHA
Relationship to You: PARENT
Have you ever been in the U.S.? NO
Have you ever been issued a U.S. visa? NO
Have you ever been refused a U.S. Visa, or been refused admission to NO
the United States, or withdrawn your application for admission at the
port of entry?
Has anyone ever filed an immigrant petition on your behalf with the NO
United States Citizenship and Immigration Services?
U.S. Contact Information
Contact Person Name in the U.S.: DO NOT KNOW
Organization Name in the U.S.: DAYS INN & SUITES BY WYNDHAM
Relationship to You: OTHER
U.S. Contact Address: DAYS INN & SUITES BY WYNDHAM
1111 S HARBOR BLVD
ANAHEIM , CALIFORNIA 92805
Phone Number: +171461657
Email Address: DOES NOT APPLY
Family Information
Father's Surnames: KUMAR
Father's Given Names: AMARESH
Father's Date of Birth: 15 DECEMBER 1965
Is your father in the U.S.? NO
Mother's Surnames: SHRIVASTAVA
Mother's Given Names: NISHA
Mother's Date of Birth: 02 JANUARY 1980
Is your mother in the U.S.? NO
Do you have any immediate relatives, not including parents in the U.S.? NO
Do you have any other relatives in the United States? NO
Work/Education/Training Information
Primary Occupation: STUDENT
Present Employer or School Name: BISHOP COTTON BOY'S SCHOOL
Address: 15, RESIDENCY ROAD
SHANTHALA NAGAR, ASHOK NAGAR
City: BENGALURU
State/Province: KARNATAKA
Postal Zone/Zip Code: 560087
Country/Region: INDIA
Work Phone Number: 08040527888
Monthly Salary in Local Currency (if employed): DOES NOT APPLY
Briefly Describe your Duties: I AM A STUDENT OF 10TH GRADE
Were you previously employed? NO
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Have you attended any educational institutions at a secondary level or YES
above?
Name of Institution (1): BISHOP COTTON BOYS' SCHOOL
Address of Institution: 15, RESIDENCY ROAD
SHANTHALA NAGAR , ASHOK NAGAR
City: BENGALURU
State/Province: KARNATAKA
Postal Zone/ZIP Code: 560025
Country/Region: INDIA
Course of Study: ACADEMIC
Date of Attendance From: 06 JUNE 2023
Date of Attendance To: 20 JULY 2025
Do you belong to a clan or tribe? NO
Provide a List of Languages You Speak:
Language Name (1): HINDI
Language Name (2): ENGLISH
Have you traveled to any countries/regions within the last five years? YES
Provide a List of Countries/Regions Visited
Country/Region (1): UNITED ARAB EMIRATES
Have you belonged to, contributed to, or worked for any professional, NO
social, or charitable organization?
Do you have any specialized skills or training, such as firearms, NO
explosives, nuclear, biological, or chemical experience?
Have you ever served in the military? NO
Have you ever served in, been a member of, or been involved with a NO
paramilitary unit, vigilante unit, rebel group, guerrilla group, or
insurgent organization?
Security and Background Information
Do you have a communicable disease of public health significance? (Communicable diseases of public significance NO
include chancroid, gonorrhea, granuloma inguinale, infectious leprosy, lymphogranuloma venereum, infectious
stage syphilis, active tuberculosis, and others diseases as determined by the Department of Health and Human
Services.)
Do you have a mental or physical disorder that poses or is likely to pose a threat to the safety or welfare of NO
yourself or others?
Are you or have you ever been a drug abuser or addict? NO
Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty, or NO
other similar action?
Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substances? NO
Are you coming to the United States to engage in prostitution or unlawful commercialized vice or have you been NO
engaged in prostitution or procuring prostitutes within the past 10 years?
Have you ever been involved in, or do you seek to engage in, money laundering? NO
Have you ever committed or conspired to commit a human trafficking offense in the United States or outside the NO
United States?
Are you the spouse, son, or daughter of an individual who has committed or conspired to commit a human NO
trafficking offense in the United States or outside the United States and have you within the last five years,
knowingly benefited from the trafficking activities?
Have you knowingly aided, abetted, assisted or colluded with an individual who has committed or conspired to NO
commit a severe human trafficking offense in the United States or outside the United States?
Do you seek to engage in espionage, sabotage, export control violations, or any other illegal activity while in the NO
United States?
Do you seek to engage in terrorist activities while in the United States or have you ever engaged in terrorist NO
activities?
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Your Personal Copy -- Do Not Bring to Interview
Have you ever or do you intend to provide financial assistance or other support to terrorists or terrorist NO
organizations?
Are you a member or representative of a terrorist organization? NO
Are you the spouse, son, or daughter of an individual who has engaged in terrorist activity, including providing NO
financial assistance or other support to terrorists or terrorist organizations, in the last five years?
Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide? NO
Have you ever committed, ordered, incited, assisted, or otherwise participated in torture? NO
Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings, political killings, NO
or other acts of violence?
Have you ever engaged in the recruitment or the use of the child soldiers? NO
Have you, while serving as a government official, been responsible for or directly carried out, at any time, NO
particularly severe violations of religious freedom?
Have you ever been directly involved in the establishment or enforcement of the population controls forcing a NO
woman to undergo an abortion against her free choice or a man or a woman to undergo sterilization against his or
her free will?
Have you ever been directly involved in the coercive transplantation of human organs or bodily tissue? NO
Have you ever sought to obtain or assist others to obtain a visa, entry into the United States, or any other United NO
States immigration benefit by fraud or willful misrepresentation or other unlawful means?
Have you ever been removed or deported from any country? NO
Have you ever withheld custody of a U.S. citizen child outside the United States from a person granted legal NO
custody by a U.S. court?
Have you voted in the United States in violation of any law or regulation? NO
Have you ever renounced United States citizenship for the purpose of avoiding taxation? NO
Location Information
Location where you will be submitting your application
Current Location: NEW DELHI, INDIA
Preparer of Application
Did anyone assist you in filling out this application? NO
Your Personal Copy -- Do Not Bring to Interview
आपने आवेदन-पत्र पर इलैक्ट्रॉनिकली हस्ताक्षर किए हैं 25-Jul-2025 01:28:45 (GMT-05:00). जब तक नियमों द्वारा छू ट नहीं हो, आपको अपने आवेदन पत्र पर इलेक्ट्रॉनिकली
हस्ताक्षर करने होंगे, आवेदन पत्र आपके अलावा किसी अन्य के द्वारा तैयार किए जाने पर भी। आपके इलेक्ट्रॉनिक हस्ताक्षर यह प्रमाणित करते हैं कि आपने इस आवेदन-पत्र में दिए गए
प्रश्नों को पढ़ और समझ लिया है, और यह कि आपकी जानकारी और विश्वास के अनुसार आपके उत्तर सत्य और सही हैं। जमा किए गए आवेदन-पत्र में झूठे या गुमराह करने वाला ब्यौरा
वीज़ा देने की हमेशा के लिए मनाही या अमेरिका में प्रवेश से मना किया जा सकता है। इस आवेदन-पत्र की सभी घोषणाएं झूठे साक्ष्य के लिए दंड के प्रावधान के तहत बिना शपथ लिए की
गई घोषणाए हैं। (28 यू.एस.सी. 1746)।
आपके आवेदन-पत्र में दी गई जानकारी और अन्य जानकारी जो आपने आवेदन-पत्र के साथ जमा की है दू सरी सरकारी एजेंसियों, कानूनी या अन्य वैधानिक अधिकारियों द्वारा कानून प्रवर्तन
और इमीग्रेशन कानून प्रवर्तन उद्देश्यों के लिए प्रयुक्त की जा सकती है। अपने आवेदन-पत्र के साथ जो फोटोग्राफ आपने दिया है वह रोजगार सत्यापन या अन्य अमेरिकी कानूनी उद्देश्यों के
लिए प्रयोग किया जा सकता
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