Nonimmigrant Visa Application

Application - Sensitive But Unclassified(SBU)

Photo Provided:

Personal, Address, Phone, and Passport Information

Name Provided: MARYI SOLANGIE TORRES TOVAR

Full Name in Native Language: DOES NOT APPLY
▲ Other Names Used: YES
Other Name (1) : NONE , RAMESHBHAI
Sex: FEMALE
Marital Status: SINGLE
Date of Birth: 17 NOVEMBER 1995
Place of Birth: BOGOTA, COLOMBIA
Nationality: COLOMBIAN
Other Nationalities: NO
National Identification Number: DOES NOT APPLY
U.S. Social Security Number: DOES NOT APPLY
U.S. Taxpayer ID Number: DOES NOT APPLY
Home Address: DIAGONAL 51 # 54 -28 SUR
City: BOGOTA
State/Province: MAHARASHTRA
Postal Zone/ZIP Code: 400034
Country: COLOMBIA
Same Mailing Address? YES
Home Phone Number: 91-238-46-96
Work Phone Number: 91-320-440-53-23
Work Fax Number: 91-22-5555-1111
Mobile/Cell Phone Number: 91-320-440-53-23
Email Address: SOLANGIETORRES1795@HOTMAIL.COM
Passport Number: A9783434
Passport Book Number: DOES NOT APPLY
Country/Authority that Issued Passport: COLOMBIA
City Where Issued: BOGOTA
State/Province Where Issued: BOGOTA
Country Where Issued: COLOMBIA
Issuance Date: 01 DECEMBER 2015
Expiration Date: 01 DECEMBER 2025
Have you ever lost a passport or had one stolen? NO

Travel Information
Purpose of Your Trip to U.S.
Purpose (1) : TOURIST/PERSONAL TRAVEL VISITOR (B2)
Intended Date of Arrival: 25 FEBRUARY 2016
Intended Length of Stay in U.S.: 3 MONTH(S)
Address where you will stay in the U.S: 123 PARK AVENUE
EDISON, NEW JERSEY 08817
Person/Entity Paying for Your Trip: OTHER PERSON
Name of Person Paying for Your Trip: MARIBEL, TOVAR
Telephone: 312-506-16-88
Email Address: MARIBELITA-24@HOTMAIL.COM
Relationship to You: MOM
Is the address of the party paying for your trip the
same as your Home or Mailing Address?
SI
Paying Address: DOES NOT APPLY
City: DOES NOT APPLY
State/Province: DOES NOT APPLY
Postal Zone/ZIP Code: 08817
Country: UNITED STATES OF AMERICA
▲ Other Persons Traveling with You: YES
Are you traveling as part of a group or
organization?
NO
Persons Traveling with You:
Name (1) : MARIBEL , TOVAR
Relationship to You: MOM
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, been
refused admission to the United States, or
withdrawn your application for admission at the
point of entry?
NO
U.S. Contact Information
Contact Person Name in the U.S.: MARIBEL , TOVAR
Organization Name in the U.S.: DO NOT KNOW
Relationship to You: RELATIVE
U.S. Contact Address: 123 PARK AVENUE
EDISON, NEW JERSEY 08817
Phone Number: (732)555-1212
Email Address: MARIBELITA-24@HOTMAIL.COM
Family Information
Father's Surnames: TOVAR
Father's Given Names: BENIGNO
Father's Date of Birth: 08 FEBRUARY 1930
Is your father in the U.S.? NO
Mother's Surnames: PEREZ
Mother's Given Names: MARIA
Mother's Date of Birth: 06 MAY 1934
Is your mother in the U.S.? NO
Do you have any immediate relatives, not
including parents in the U.S.?
▲ YES
Relative Name (1) : MARIBEL , TOVAR
Relationship to you: MOM
Status: U.S. CITIZEN
Spouse's Full Name: DOES NOT APPLY
Spouse's Date of Birth: DOES NOT APPLY
Spouse's Nationality: DOES NOT APPLY
Spouse's City of Birth: DOES NOT APPLY
Consular Electronic Application Center - Print Application Page 2 of 4
Spouse's Country of Birth: DOES NOT APPLY
Spouse’s Address: DOES NOT APPLY
Work / Education / Training Information
Primary Occupation: DOES NOT APPLY
Present Employer or School Name: DOES NOT APPLY
Address: DOES NOT APPLY
City: DOES NOT APPLY
State/Province: DOES NOT APPLY
Postal Zone/Zip Code: DOES NOT APPLY
Country: DOES NOT APPLY
Month Salary in Local Currency: 45,000
Briefly Describe your Duties: SALESMAN
Security and Background Information
Do you have a communicable disease of public
health significance such as tuberculosis (TB)?
NO
Do you have a mental or physical disorder that
poses or is likely to pose a threat to the safety or
welfare of yourself or others?
NO
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 other similar action?
NO
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 engaged in prostitution or
procuring prostitutes within the past 10 years?
NO
Have you ever been involved in, or do you seek to
engage in, money laundering?
NO
Do you seek to engage in espionage, sabotage,
export control violations, or any other illegal
activity while in the United States?
NO
Do you seek to engage in terrorist activities while
in the United States or have you ever engaged in
terrorist activities?
NO
Have you ever or do you intend to provide
financial assistance or other support to terrorists
or terrorist organizations?
NO
Are you a member or representative of a terrorist
organization?
NO
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, or other acts of violence?
NO
Have you, while serving as a government official,
been responsible for or directly carried out, at any
time, particularly severe violations of religious
freedom?
NO
Have you ever sought to obtain or assist others to
obtain a visa, entry into the United States, or any
other United States immigration benefit by fraud
or willful misrepresentation or other unlawful
means?
NO
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?
NO
Have you voted in the United States in violation of NO
Consular Electronic Application Center - Print Application Page 3 of 4
any law or regulation?
Have you ever renounced United States
citizenship for the purpose of avoiding taxation?
NO

Location Information
Current Location: BOGOTA , COLOMBIA

Preparer of Application:
Did anyone assist you in filling out this application? NO