DO NOT PRINT THIS PAGE. You must click the "Continue" button below and then print the form to complete the process. Please do not click the "Continue" button more than once. Your answers must be in English and must use English characters.

请不要打印此页。您必须点击下面的[继续]按钮，然后再打印此表格以完成填写过程。请不要多次点击[继续]按钮。

您必须用英文做答且只能键入英文字符。

Image of the State Seal

U.S. Department of State
NONIMMIGRANT VISA APPLICATION

美国国务院
非移民签证申请表

 

Approved OMB 1405-0018
Expires 09/30/2007
Estimated Burden 1 hour
See Page 2

PLEASE TYPE OR PRINT YOUR ANSWERS IN THE SPACE PROVIDED BELOW EACH ITEM

请在表格每项下面提供的空格处键入答案



City城市

Country国家

State/Province州/省

DO NOT WRITE IN THIS SPACE

请勿填写此处


day 日

month 月

year 年


day 日

month 月

year 年






day 日

month 月

year 年

出生地点

City城市

Country国家

State/Province州/省



Male 男

Female 女



Street Address Line 1 街道名称(第一行)

Street Address Line 2 街道名称(第二行)

City城市

State/Province州/省

Postal Code 邮政编码

Country 国家

16.







Married已婚 Single (Never Married) 单身(未婚)
Widowed丧偶 Divorced离婚 Separated分居


day 日

month 月

year 年

Name名称:

Address地址:


(如有确定日期,请提供)

day 日

month 月

year 年

 



Street Address Line 1 街道名称(第一行)

Street Address Line 2 街道名称(第二行)

City城市

State/Province州/省

Postal Code邮政编码

Barcode

条形码


Name姓名

Home Phone住宅电话

Business Phone工作电话

Cell Phone手机号码

DO NOT WRITE IN THIS SPACE

请勿填写此处

|
50mm X 50 mm

50毫米X 50毫米
|
PHOTO

照片
|
Glue photo here.

请用胶水将照片粘贴于此处。
|



Yes是 No否

WHEN? 何时?
(Most Recent最近一次)

day日

month月

year年

FOR HOW LONG? 逗留了多久?

Enter Additional Visits to the U.S. Here: 请在此填写其它访美及停留时间:

DS-156
02-2003

PREVIOUS EDITIONS OBSOLETE

Page 1 of 2

 

Yes 是 No否

WHEN?何时?
(Most Recent最近一次)

day日

month月

year年

WHERE? 在何地?
WHAT TYPE OF VISA? 哪类签证?
Enter Additional Visa Issuances Here: 请在此填写其它获签记录:

Yes是 No否

WHEN?何时?
(Most Recent最近一次)

day日

month月

year年

WHERE?在何地?
WHAT TYPE OF VISA? 哪类签证?


Enter Additional Visa Refusals Here: 请在此填写其它拒签记录:

Yes是 No否
(If YES, give the name and complete address of U.S. employer.)

(如有意就业，请提供美国雇主的名称及地址。)

Yes是 No否
(If YES, give the name and complete address of the school.)

(如有意就读,请提供美国学校的名称和地址。)


Yes是 No否


Yes有 No没有   If Yes, Who? 如有，是谁？

37. Are Any of The Following Persons in The U.S., or Do They Have U.S. Legal Permanent Residence or U.S. Citizenship? 下列亲属中是否有人目前已在美国？他们是否是美国合法永久居民或美国公民？
Mark YES or NO and indicate that person's status in the U.S. (i.e., U.S. legal permanent resident, U.S. citizen, visiting, studying, working, etc.)

请注明“在美国”、“不在美国”，并注明其在美国的身份（即：是美国合法永久居民还是美国公民，是否正在美国访问、留学、工作等）

Yes在美国 No不在美国


  

Yes在美国  No不在美国


  

Yes在美国  No不在美国

Yes在美国 No不在美国


 

Yes在美国  No不在美国


 


38. IMPORTANT: ALL APPLICANTS MUST READ AND CHECK THE APPROPRIATE BOX FOR EACH ITEM. 请注意：每位申请人都必须通读并回答下列所有问题。
A visa may not be issued to persons who are within specific categories defined by law as inadmissible to the United States (except when a waiver is obtained in advance). Is any of the following applicable to you? 美国相关法律把某几类人界定为禁止进入美国的人，故不得向这些人签发签证（但事先得到酌情免除者例外）。下列各项是否适用于您？

  • Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty or other similar legal action? Have you ever unlawfully distributed or sold a controlled substance (drug), or been a prostitute or procurer for prostitutes?

Yes 是 No 否

  • Have you ever been refused admission to the U.S., or been the subject of a deportation hearing or sought to obtain or assist others to obtain a visa, entry into the U.S., or any other U.S. immigration benefit by fraud or willful misrepresentation or other unlawful means? Have you attended a U.S. public elementary school on student (F) status or a public secondary school after November 30, 1996 without reimbursing the school?

Yes 是 No 否

  • Do you seek to enter the United States to engage in export control violations, subversive or terrorist activities, or any other unlawful purpose? Are you a member or representative of a terrorist organization as currently designated by the U.S. Secretary of State? Have you ever participated in persecutions directed by the Nazi government of Germany; or have you ever participated in genocide?

Yes 是 No 否

  • Have you ever violated the terms of a U.S. visa, or been unlawfully present in, or deported from, the United States?

Yes 是 No 否

  • Have you ever withheld custody of a U.S. citizen child outside the United States from a person granted legal custody by a U.S. court, voted in the United States in violation of any law or regulation, or renounced U.S. citizenship for the purpose of avoiding taxation?

Yes 是 No 否

  • Have you ever been afflicted with a communicable disease of public health significance or a dangerous physical or mental disorder, or ever been a drug abuser or addict?

Yes 是 No 否

While a YES answer does not automatically signify ineligibility for a visa, if you answered YES you may be required to personally appear before a consular officer.

当上述任何一项答案为“是”并不代表签证自动被拒签，如您回答为“是”，您本人须亲临本处与领事馆官员面谈

Was this Application Prepared by Another Person on Your Behalf?      Yes 是 No 否
(If answer is YES, then have that person complete item 40. 如由他人代为填写，则请代笔人填写第40栏)

Application Prepared By:
NAME姓名:      Relationship to Applicant与申请人的关系:
ADDRESS住址:

Signature of Person Preparing Form 申请表代填人签字____________________________________________  DATE (dd-month-yyyy)日期（日-月-年）__________________________

41. I certify that I have read and understood all the questions set forth in this application and the answers I have furnished on this form are true and correct to the best of my knowledge and belief. I understand that any false or misleading statement may result in the permanent refusal of a visa or denial of entry into the United States. I understand that possession of a visa does not automatically entitle the bearer to enter the United States of America upon arrival at a port of entry if he or she is found inadmissible. 我特此确认，本申请表中所有问题本人均已通读领会，且本人在申请表上所做之回答就本人所知均属实无误。本人确知，任何谬误或误导之辞都可能导致本人永远被拒签或永远不得进入美国。本人确知，签证持有人如被认定为不许入境者，则不得因持有签证而自动享受抵达入境口岸即可进入美国的权利。

APPLICANT'S SIGNATURE 申请人签字____________________________________________   DATE (dd-month-yyyy) 日期（日-月-年）___________________________

Privacy and Paperwork Reduction Act Statements 《隐私权法》及《减少文书档案法》节录

INA Section 222(f) provides that visa issuance and refusal records shall be considered confidential and shall be used only for the formulation, amendment, administration, or enforcement of the immigration, nationality, and other laws of the United States. Certified copies of visa records may be made available to a court which certifies that the information contained in such records is needed in a case pending before the court.

《移民归化法》第222条（f）规定，签证之签发及拒签的有关卷宗均须作为保密资料对待，只能用于美国《移民法》、《国籍法》及其他法律的规定、修订、管理或执行。在有关法庭确认其审理的案件需要签证卷宗所含资料时，则经确认的签证卷宗副本可提供给该法庭。

Public reporting burden for this collection of information is estimated to average 1 hour per response, including time required for searching existing data sources, gathering the necessary data, providing the information required, and reviewing the final collection. You do not have to provide the information unless this collection displays a currently valid OMB number. Send comments on the accuracy of this estimate of the burden and recommendations for reducing it to: U.S. Department of State, A/RPS/DIR, Washington, DC 20520.

本类索取资料的表格对填表公众的负担预计平均为每份表格一小时，这包括查阅现有资料、收录必要资料、提供表格所需资料及审核表格最后填报情况的时间。您不必提供没有标明有效OMB号码的任何表格所索取的资讯。本估计是否准确，您建议如何减轻填表负担？敬请赐教。来函请寄：U.S. Department of State, A/RPS/DIR, Washington, DC 20520

DS-156

Page 2 of 2

DO NOT PRINT THIS PAGE. You must click the "Continue" button below and then print the form to complete the process. Please do not click the "Continue" button more than once. Your answers must be in English and must use English characters.

请不要打印此页。您必须点击下面的[继续]按钮，然后再打印此表格以完成填写过程。请不要多次点击[继续]按钮。

您必须用英文做答且只能键入英文字符。

Clicking on the "Generate Family Duplicate" button will copy some of the values into a new online DS-156 application form. Please click here for more information on this feature.

点击“制造家庭成员副本”按钮可以将您申请表上填写的部分信息自动复制到一份新的DS-156表上，

请点击here 获悉此功能的更多相关信息。

  

 

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