9/17/2019 Non-Immigrant Visa - Review Personal, Address, Phone, and Passport Information
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Online Nonimmigrant Visa Application (DS-160) Application ID AA0098BR9T
Personal, Address, Phone, and Passport Information
Note: You have completed data entry for your NIV application. Before submitting the application, please review your entries below. To
navigate to the next section to be reviewed, click the ‘Next’ button on the bottom of the page. If an entry is incorrect, click on the links
on the right side of the page, which will direct you to the page where you entered the data. Once you have reviewed all sections, you
will be directed to the Sign and Submit page to complete the application process.
Photo Provided:
DO NOT BRING THIS TO YOUR INTERVIEW
Edit Personal Information
Name Provided: FERNADES PEREREIRA, TIE
Full Name in Native Alphabet: TIE FERNANDES PEREIRA
Other Names Used: NO
Telecode Name Used: NO
Sex: MALE
Marital Status: SINGLE
Date of Birth: 09 MAY 1982
Country/Region of Birth: JOINVILLE, SANTA CATARINA,
BRAZIL
Country/Region of Origin (Nationality): BRAZIL
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: 4145910
U.S. Social Security Number: DOES NOT APPLY
U.S. Taxpayer ID Number: DOES NOT APPLY
Edit Address and Phone Information
Home Address: RUA DAS FOLHAS VERDES 50
CORREGO GRANDE
City: FLORIANOPOLIS
State/Province: SANTA CATARINA
Postal Zone/ZIP Code: 88037540
Country/Region: BRAZIL
Same Mailing Address? YES
DO NOT BRING THIS TO YOUR INTERVIEW
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9/17/2019 Non-Immigrant Visa - Review Personal, Address, Phone, and Passport Information
DO NOT BRING THIS TO YOUR INTERVIEW
Primary Phone Number: 48996122009
Secondary Phone Number: DOES NOT APPLY
Work Phone Number: DOES NOT APPLY
Have you used additional phone numbers in the last five years?
Have you used additional email addresses in the last five years?
Do you have a social media presence?
Social Media Provider/Platform (1): INSTAGRAM
Social Media Identifier: @TIE.BASS
Have you used additional social media platforms in the last five years?
Edit Passport/Travel Document Information
Passport/Travel Document Type: REGULAR
Passport/Travel Document Number: GA033894
Passport Book Number: DOES NOT APPLY
Country/Authority that Issued Passport/Travel Document: BRAZIL
City where issued: FLORIANOPOLIS
State/Province where issued: SANTA CATARINA
Country/Region where issued: BRAZIL
Issuance Date: 05 AUGUST 2019
Expiration Date: 04 AUGUST 2029
Have you ever lost a passport or had one stolen? NO
DO NOT BRING THIS TO YOUR INTERVIEW
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