U.S. Department of State
SUPPLEMENTAL QUESTIONS FOR VISA APPLICANTS
美国国务院
签证申请人补充问题
Approved OMB 1405-0226 Expires 02/28/2021 Estimated Burden 60 Minutes
General Instructions
• If you are unsure of the answer to a question, please provide a response to the best of your knowledge. For example, if you are unsure of an exact address, provide the city, state, and street name if you can recall them. U.S. Department of State will consider all the information derived from the form in its entirety.
• Failure to answer every question will not necessarily preclude visa issuance, as the application is considered in its entirety.
• If you believe a particular question does not apply to you or your circumstances, please write "not applicable" or "N/A."
• If you need more space to respond to a question, please write the rest of your response on a separate sheet of paper.
• Aside from your name, date of birth, and visa classification, please only provide information not included in your current visa application. For example, if all of your children are listed in your current visa application (Form DS-160 or DS-260), you do not need to list them again.
•如果你对某个问题的答案不确定，请尽你所能给出一个答案。例如，如果您不确定确切的地址，如果您能回忆起，请提供城市、州和街道名称。美国国务院将全面审议该表格提供的所有信息。
•未能回答每一个问题并不一定会妨碍签证的发放，因为申请是被完整考虑的。
•如果你认为某一特定问题不适用于你或你的情况，请写下“不适用”或“不适用”。
•如果你需要更多的空间来回答问题，请把剩下的答案写在另一张纸上。
•除您的姓名、出生日期和签证类别外，请仅提供当前签证申请中未包含的信息。例如，如果您当前的签证申请表(表格DS-160或DS-260)中列出了您所有的孩子，您就不需要再次列出他们。
Personal Information
个人信息
Surname(s)姓
Given Name(s)名
Date of Birth (mm-dd-yyyy)出生日期（月-日-年）
Visa Type/Classification签证类型/分类
Passport and Travel History
护照和旅行历史
Have you travelled to any country (other than your country of residence) in the last 15 years? Yes No If yes, provide details for each trip, including locations visited, date visited, source of funds, and length of stay.
在过去15年，你有否到过其他国家(不包括你的居住国)旅游? 是 否
如果是，提供每次旅行的详细信息，包括访问地点、访问日期、资金来源和停留时间。
Have you ever held a passport other than the passport listed in your visa application? Yes No
If yes, provide the following information.
除了签证申请中所列的护照外，您是否曾持有其他护照? 是 否
如果是，请提供以下信息。
Country of Issuance签发国家
Passport Number
护照号码
Relatives亲属
Siblings (brothers and sisters) - Provide the full name(s) and date of birth of any sibling (full, half, step, adopted), living or deceased.
兄弟姐妹-提供所有在世的、已故的兄弟姐妹(包括同母同父的、同父异母的、同母异父的、堂/表的、收养的)的全名和出生日期。
Surname(s)姓
Given Name(s)名
Date of Birth (mm-dd-yyyy)
出生日期（月-日-年）
Children - Provide the full name(s) and date of birth of any child (minor and adult), living or deceased. Children includes natural children, step-children, and adopted children.
子女-提供所有子女(未成年人及成人)、在世或已故的全名及出生日期。子女包括自然子女、继子女和收养子女。
Surname(s)姓
Given Name(s)名
Date of Birth (mm-dd-yyyy)
出生日期（月-日-年）
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Relatives - Continued亲属-继续
Spouse - Provide the full name(s) of any current or previous spouse or civil/domestic partner, living or deceased.
配偶-提供所有在世或已故的现任或前任配偶或民事/家庭伴侣的全名。
Surname(s)
姓
Given Name(s)名
Date of Birth (mm-dd-yyyy)
出生日期（月-日-年）
Address and Contact Information地址和联系方式
Address - Provide all addresses where you have lived during the last 15 years, if not already provided in your application.
地址-提供你在过去15年居住的所有地址，如果你的申请中没有提供的话。
Address 1
Address 2
Dates of Residence (mm-dd-yyyy)
居住日期（月-日-年）
Dates of Residence (mm-dd-yyyy)
居住日期（月-日-年）
Street Address 1
街道地址1
Street Address 1
街道地址1
Street Address 2
街道地址2
Street Address 2
街道地址2
City城市
State/Province州/省份
City城市
State/Province州/省份
Postal Zone/Zip Code邮政区/邮政编码
Country/Region国家/地区
Postal Zone/Zip Code邮政区/邮政编码
Country/Region国家/地区
Phone Number - Provide all phone numbers you have used in the last five years, including primary, secondary, work, home, and mobile numbers.
电话号码-提供你在过去五年里使用过的所有电话号码，包括小学、中学、工作、家庭和手机号码。
Phone Number (1)电话号码1
Phone Number (2)电话号码2
Phone Number (3)电话号码3
Phone Number (4)电话号码4
Phone Number (5)电话号码5
Phone Number (6)电话号码6
Phone Number (7)电话号码7
Phone Number (8)电话号码8
E-mail - Provide all email addresses you have used in the last five years, including primary, secondary, work, personal, and educational addresses.
电子邮件-提供您在过去五年使用的所有电子邮件地址，包括小学、中学、工作、个人和教育地址。
E-mail Address (1)电子邮件地址1
E-mail Address (2)电子邮件地址2
E-mail Address (3)电子邮件地址3
E-mail Address (4)电子邮件地址4
E-mail Address (5)电子邮件地址5
E-mail Address (6)电子邮件地址6
Social Media社交媒体
Please provide your unique user name for any websites or applications you have used to create or share content (photos, videos, status updates, etc.) as part of a public profile within the last five years. (You do not need to list accounts designed for use by multiple users within a business or other organization.)
请为您在过去五年内用于创建或共享内容(照片、视频、状态更新等)的任何网站或应用程序提供您唯一的用户名，作为公共简介的一部分。(您不需要列出为业务或其他组织中的多个用户设计的帐户。)
Social Media Platform
社交媒体平台
Social Media Identifier (Name/Handle)
社交媒体用户名
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Employment History工作经历
Provide the following information on all employment in the last fifteen years, if not already provided in your application.
如果你的申请中没有提供过去15年的所有就业情况，请提供以下信息。
Employer Name单位名称
Employer Name单位名称
Dates of Employment (mm-dd-yyyy)雇佣日期
Dates of Employment (mm-dd-yyyy)雇佣日期
Street Address 1街道地址1
Street Address 1街道地址1
Street Address 2街道地址2
Street Address 2街道地址2
City城市
State/Province州/省份
City城市
State/Province州/省份
Postal Zone/Zip Code邮政区/邮政编码
Country/Region国家/地区
Postal Zone/Zip Code邮政区/邮政编码
Country/Region国家/地区
Telephone Number电话号码
Telephone Number电话号码
Job Title职业
Job Title职业
Job Description工作描述
Job Description工作描述
I understand all the information I have provided in, or in support of, this application may be provided to other U.S. government agencies authorized to use such information for purposes including enforcement of the laws of the United States. I understand all of the information contained in this form and I certify under penalty of perjury under the laws of the United States of America that the foregoing is complete, true, and correct. I understand that any willfully false or misleading statement or willful concealment of a material fact made by me herein may result in refusal of the visa, denial of admission to the United States, and, may subject me to criminal prosecution and/or removal from the United States.
本人明白本人在本申请书中所提供或支持的所有资料，可能会提供给其他获授权使用该等资料作包括执行美国法律之用的美国政府机构。本人明白本表格所载的一切资料，并根据美利坚合众国法律，以伪证论处，兹证明上述内容完整、真实及正确。本人明白，任何故意作出虚假或误导的陈述，或故意隐瞒本人在此所作的重要事实，均可能导致本人被拒签、被拒绝入境美国，并可能被刑事起诉及/或被驱逐出境。
Applicant's Signature申请人签名
Date (mm-dd-yyyy)日期（日-月-年）
For use by United States embassy or consulate official only:
仅供美国大使馆或领事馆官员使用:
DS-160/DS-260 Barcode Number
DS-160/DS-260条形码号码
PAPERWORK REDUCTION ACT STATEMENT
Public reporting burden for this collection of information is estimated to average 60 minutes per response, including time required for searching existing data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to: PRA_BurdenComments@state.gov.
估计每次答复的公开报告负担平均为60分钟，包括搜索现有数据源、收集必要的文件、提供所需的信息和/或文件以及审查后收集所需的时间。您不必提供此信息，除非此集合显示当前有效的OMB控件号。如果您对这一负担估计的准确性和/或减少负担的建议有任何意见，请发送到:PRA_BurdenComments@state.gov。
ConFIDENTIALITY STATEMENT
AUTHORITIES: The information on this form is requested pursuant to Section 212(a) and 221 and as required by Section 222 of the Immigration and Nationality Act. Section 222(f) provides that the records of the Department of State and of diplomatic and consular offices of the United States pertaining to the issuance and refusal of visas or permits to enter the United States 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 such records may, in the discretion of the Secretary of State, be made available to a court provided the court certifies that the information contained in such records is needed in a case pending before the court.
当局:根据《移民和国籍法》第212(a)条和第221条以及第222条的要求，要求提供关于本表格的资料。Section 222 (f)提供的记录国务院和美国外交和领事机构的有关签证或许可的发行和拒绝进入美国应当被视为机密,只应使用配方,修正案,政府,或执行的移民,美国国籍,和其他法律。如果法院证明在法院审理的案件中需要这些记录中所载的资料，则可根据国务秘书的酌定，向法院提供这些记录的核证副本。
PURPOSE: The U.S. Department of State uses the information provided on this form to determine an individual’s eligibility for a U.S. visa. Individuals who fail to submit this form or who do not provide all the requested information may be denied a U.S. visa. Although furnishing this information is voluntary, failure to provide this information may delay or prevent the processing of an individual visa application.
目的:美国国务院使用此表格上提供的信息来确定个人申请美国签证的资格。未提交此表格或未提供所有所需信息的个人可能被拒签美国签证。虽然提供这些信息是自愿的，但不提供这些信息可能会延迟或阻碍个人签证申请的处理。
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