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: VERMA, ASHWANI KUMAR
Full Name in Native Language: ASHWANI KUMAR VERMA
Other Names Used: NO
Telecode Name Used: NO
Sex: MALE
Marital Status: MARRIED
Date of Birth: 06 FEBRUARY 1972
Place of Birth: BUDAPEST, PUNJAB, 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: DOES NOT APPLY
U.S. Social Security Number: DOES NOT APPLY
U.S. Taxpayer ID Number: DOES NOT APPLY
Home Address: RZ B-18 DABRI EXTN. EAST, GALI NO. 2
NEAR GOPAL MANDIR
Your Personal Copy -- Do Not Bring to Interview
Your Personal Copy -- Do Not Bring to Interview
City: NEW DELHI
State/Province: DELHI
Postal Zone/ZIP Code: 110045
Country/Region: INDIA
Same Mailing Address? NO
Mailing Address: PODMANICZKY UTCA 81
2 FLOOR, DOOR NO. 19
City: BUDAPEST
State/Province: BUDAPEST
Postal Zone/ZIP Code: 1064
Country/Region: HUNGARY
Primary Phone Number: 06308738610
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): NONE
Social Media Identifier:
Do you have any additional social media presence? NO
Passport/Travel Document Type: REGULAR
Passport/Travel Document Number: L9051543
Passport Book Number: DOES NOT APPLY
Country/Authority that Issued Passport/Travel Document: INDIA
City Where Issued: NEW DELHI
State/Province Where Issued: DELHI
Country/Region Where Issued: INDIA
Issuance Date: 08 MAY 2014
Expiration Date: 07 MAY 2024
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 PLEASURE
VISITOR (B)
Specify: BUSINESS & TOURISM
(TEMPORARY VISITOR) (B1/B2)
Have you made specific travel plans? NO
Intended Date of Arrival: 01 JUNE 2023
Intended Length of Stay in U.S.: 15 DAY(S)
Your Personal Copy -- Do Not Bring to Interview
Your Personal Copy -- Do Not Bring to Interview
Address where you will stay in the U.S.: 19522 CORBY AVE,
CERRITOS
City, State, Postal/Zip Code: CA, CALIFORNIA 90703
Person/Entity Paying for Your Trip: OTHER PERSON
Person Paying for Your Trip: KUMAR , VINOD
Telephone Number: +12134422786
Relationship to You: OTHER
Is the address of the party paying for your trip the same as your Home NO
or Mailing Address?
Payer's Address: 19522 CORBY
AVE,
CERRITOS
City: CA
State/Province: CALIFORNIA
Postal Zone/ZIP Code: 90703
Country/Region: UNITED STATES OF AMERICA
Are there other persons traveling with you? NO
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 YES
the United States, or withdrawn your application for admission at the
port of entry?
Explain: NO FEEDBACK GIVEN
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.: KUMAR, VINOD
Organization Name in the U.S.: DO NOT KNOW
Relationship to You: OTHER
U.S. Contact Address: 19522 CORBY AVE,
CERRITOS
CA, CALIFORNIA 90703
Phone Number: +12134422786
Family Information
Father's Surnames: VERMA
Father's Given Names: BHIM SEN
Father's Date of Birth: 10 APRIL 1954
Is your father in the U.S.? NO
Mother's Surnames: RANI
Mother's Given Names: RAJ
Your Personal Copy -- Do Not Bring to Interview
Your Personal Copy -- Do Not Bring to Interview
Mother's Date of Birth: 10 APRIL 1954
Is your mother in the U.S.? YES
Status: NONIMMIGRANT
Do you have any immediate relatives, not including parents in the U.S.? YES
Relative Name (1): KUMAR, VINOD
Relationship to you: SIBLING
Status: U.S. LEGAL PERMANENT RESIDENT (LPR)
Spouse's Full Name: VERMA, NEERAJ
Spouse's Date of Birth: 19 NOVEMBER 1976
Spouse's Country/Region of Origin (Nationality): INDIA
Spouse's City of Birth: PUNJAB
Spouse's Country/Region of Birth: INDIA
Spouse’s Address: SAME AS HOME ADDRESS
Work/Education/Training Information
Primary Occupation: OTHER
Specify Other: PRIVATE EMPLOYEE
Present Employer or School Name: OM SAI KFT
Address: SZINYEI MERSE STREET 1.
City: BUDAPEST
State/Province: BUDAPEST
Postal Zone/Zip Code: 1063
Country/Region: HUNGARY
Work Phone Number: 06305840922
Monthly Salary in Local Currency (if employed): 160000
Briefly Describe your Duties: MANAGING DAILY TASKS IN A REST
UARANT BUSINESS LOOKING AFTER
CUSTOMERS
Were you previously employed? NO
Have you attended any educational institutions at a secondary level or NO
above?
Do you belong to a clan or tribe? NO
Provide a List of Languages You Speak:
Language Name (1): HINDI
Language Name (2): PUNJABI
Have you traveled to any countries/regions within the last five years? YES
Provide a List of Countries/Regions Visited
Country/Region (1): HUNGARY
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
Your Personal Copy -- Do Not Bring to Interview
Your Personal Copy -- Do Not Bring to Interview
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?
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
Your Personal Copy -- Do Not Bring to Interview
Your Personal Copy -- Do Not Bring to Interview
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: LJUBLJANA, SLOVENIA
Preparer of Application
Did anyone assist you in filling out this application? NO
Your Personal Copy -- Do Not Bring to Interview
You electronically signed your application on 15-Apr-2023 06:30:06 (GMT-05:00). You were required to electronically sign your
application yourself, unless otherwise exempt by regulation, even if the application was prepared by someone other than yourself.
Your electronic signature certifies that you have read and understood the questions in this application and that your answers are true
and correct to the best of your knowledge and belief. The submission of an application containing any false or misleading statements
may result in the permanent refusal of a visa or the denial of entry into the United States. All declarations made in this application
are unsworn declarations made under penalty of perjury. (28 U.S.C. 1746).
You certified that you understand that you are required to submit your visa to the United States Immigration Officer at the port
where you apply to enter the United States, and that possession of the visa does not entitle you to enter the United States if, upon
your arrival, you are found to be inadmissible under U.S. immigration laws. You certified that you understand that any willfully false
or misleading statement or willful concealment of a material fact made by you within the application may subject you to permanent
exclusion from the United States and, if you are admitted to the United States, may subject you to criminal prosecution and/or
deportation.
The information that you have provided in your application and other information submitted with your application may be accessible
to other government agencies having statutory or other lawful authority to use such information, including for law enforcement and
immigration law enforcement purposes. If fingerprints are collected as part of your application process, they may be used for the
purpose of comparing them to other fingerprints in the FBI’s Next Generation Identification (NGI) fingerprint system or its successor
systems (including civil, criminal, and latent fingerprint repositories). The photograph that you provide with your application may be
used for employment verification or other U.S. law purposes.
