Professional Documents
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And Phone: Personal, Address, Information
And Phone: Personal, Address, Information
And Phone: Personal, Address, Information
Note: You ha ve' completed data erit ry for your !Imm igrant V is a amd Alien Ré gistrat ion’ ap plicat ion'. B efo re s ubmitting th'e
application , plea s e re vie w your entrie s b elo w . To na gate t o the ne xt sect! on to be rev iéw e d, click the ‘Next’ biutt on on the
botto rh of' the p ag'e . If a'n entry is i na rre ct, click on. the li nk s on the rig ht side of the pa ge, w hich. w i\ I direct y ou t o the pa ge
where you ent ere d the data . On ce you hav e reyie w ed al| section s, you w ill be direct ed to the Fign and Submit p ag e' to
comp lete the ap plicat ion prole s s.
Oocument Type:
BA hlGLADE
Document ID :
SH
Country/Authority th'at Issued IDocument : PASSPORT
I s suance Date: EF 0374594
E x pirati on Date: BANGLADESH
Do you hold or have you held any nation ality other than the 24 FEBRLIARY 2020
one you have indicated aöove?
23 FEBRLIARY 2025
P resent Ad dres s: NO
Family Information
Father’s Surname s:
WADUD
Father’s Giv en Names:
MOHAMMED ABDUL
D at e of Birth:
01 JUNE 1970
City of Birth:
CHATTO GR AM
State/Pro vince of Birth:
DO NOT KNOW
Country/R egion of Birth:
BANGLADESH
I s y our father stil I liv ing? YES
Current A ddre ss: HOUSE 2 7, ROAD 02, MO W SHUM I
us es ? Do y ou ha v e an y children? NO
NO
Onliù e. Immigrant Vi sa and Ali en R egistrati en Applicattön @ S- 260)
Petitioner Information
Do y ou ha v e a a mmuni cabIe dise ase of publie he alth significan ce s uch a s tub erculo sis (TB) ? NO
Do y ou ha v e do cumentation to estab lish th at you ha ve re ceiv ed v accin at ions in a cco rd ance w ith U .S. Ia w
? YES
Do you have a mental or ph y sical di sorder that poses or is likely to pose a threat to the safety or welfare
NO of yourself or others?
A re you o r ha ve you e ver be en a drug abuse r or a ddict ? NO
Ha v e y ou e ver be en arreste d or conv icte d for an y off en se o r crime, e ven th ough s ubj ect of a pard on, NO
amnesty, or other similar a ct ion?
Ha v e y ou e ver vi oIat ed, o r en ga ged in a cons pira cy to vi oIate, an y Iaw rel at ing t o co ntroIIed s ub st ance s ?
NO
A re you the s pou se, s on, or daught er of an indiv idu al wh o has violate d an y œntrolled s ub stanœ
NO traffick ing Iaw, and hav e kno w ingl y b enefite d fram the traffickin g a ctivit ies in the p ast fiv e y ea rs?
A re you coming to the Unite d St at es to en ga ge in prosti tution o r unIa wful a mmerci ali z e d vice o r hav e
NO y ou be en en gag e d in pro stitut ion o r pro curing prost itute s w ithin the p ast 10 y ea rs?
Ha v e y ou e ver be en in v ol ved in, or do y ou se ek to en ga ge in, money Iaunde ri ng? NO
Ha v e y ou e ver a mmitte d or cons pired to commit a hum an traffick ing off en se in the Unite d State s or NO
outside the Unit ed States ?
Ha v e y ou e ver kno w ingl y aided, ab ette d, a s sist ed, o r colluded w ith an indi vi dual wh o ha s b een ident ifie
d
NO b y the P resident of the Unite d St at es a s a p ers on wh o play s a significant role in a sev ere form of
traffick ing in p ers on s ?
A re you the s pou se, s on, or daught er of an indiv idu al wh o has committ ed o r consp ire d t o commit a NO
hum an t raffickin g offen se in the Unite d St at es o r outside the Unit ed State s and hav e y ou w ithin the Iast
fiv e y ea rs, know i ngl y b en efite d from the t raffickin g a ct ivit ies ?
Do y ou se ek to en ga ge in e sp iona ge, s ab ota ge, e xp o rt control v iol at ion s, o r an y other illeg al activ ity
while NO in the Unite d St at es ?
NO o rganiz ation s?
A re you a member or rep res entati v e of a t errori st o rganiz at ion? NO
A re you the s pou se, s on, or daught er of an indiv idu al wh o has en ga ged in terrorist a ct ivit y, includin g NO
prov idin g fin ancial as sistanœ or other s upp o rt t o t erro rists o r t errori st o rganiz ation s, in the Ia
st five y ea rs?
Ha v e y ou e ver ordere d, incit ed, committ ed, a s siste d, o r otherw ise p articip ate d in gen o ci de ?
NO Ha v e y ou e ver a mmitte d, ordere d, incit ed, a s siste d, o r otherw ise p articip ate d in t orture ?
NO
Ha v e y ou committed, o rdered, incite d, as siste d, or otherw ise particip at ed in e xt rajudiô al ki IIin gs, p olitical
NO k illings, o r other a ct s of violenœ ?
Ha v e y ou e ver en ga ged in the re cruit ment of o r the use of child s oldiers ? NO
Ha v e y ou, while servin g a s a go vemment offi ci al, b een res p on sibIe for o r directl y carried out, at an y time, NO
part icularl y se vere v iolation s of rel igiou s fre e dom ?
A re you a member of o r affiliate d w ith the Communist o r other totalita rian party? NO
Ha v e y ou e ver dire ctly o r indire ctly a s sist ed o r s upp o rt ed an y of the group s in Columb ia kno w n a s the
NO R ev olution ary Armed Fo rœ s of Columb ia (FARC) , Nation al Lib eration Arm y (ELN), o r Unite d Self- Defen
se
Fo rces of Columbia (AUC) ?
Have you ever, through abuse of go vernmental or politic a I position converted for personal gain, NO
confiscated or expropriated property in a foreign nation to which a United States nationa I had claim of
ownership?
Areyou thespouse, minor chitd,or agentofan indvduat who hasthrough abuseofgovernmentat or NO
politica I position converted for persona I gain, confiscated or expropriated property in a foreign nation to
which a United States national had claim of ownership?
Have you ever been direc tly invol ved in the establishment or enforcement of population controls forcing a NO
woman to undergo an abortion agai nst her free choice or a ma n or a woman to undergo sterilization
against his or her free choice?
Have you ever disc losed or trafficked in confidential U.S. business information obta ined in connection with NO
U.S. participation in the Chemical Wea pons Convention?
Are you the spouse, minor child, or agent of a n individua I who has disc losed or trafficked in confidential NO
U.S. business information obtai ned in connection with U.S. participation in the Chemica I Weapons
Convention?
Have you ever sought to obtain or assist others to obtain a visa, entry into the United States, or a ny other NO
United States immigration benefit by fraud or willful misrepresentation or other unlawful mea ns?
Have you ever been removed or depo rted from any cou ntry? NO
Have you ever withheld custody of a U.S. citizen child outside the United States from a person granted NO
legal custody by a U.S. court?
Have you ever intentionally assisted another person in withholding custody of a U.S. citizen child outside NO
the United States from a person granted lega I custody by a U.S. cou rt?
Have you voted in the United States in violation of any law or regulation ? NO
Have you ever renounced United States citizenship for the purpose of avoiding taxation? NO
Have you attended a public elementary school or a public secondary school on student (F) status after NO
November 30, 1996 without reimbursing the school?
Do you seek to enter the United States for the purpose of performing skilled or unskilled la bor but have NO
not yet been certified by the Sec reta ry of Labor?
Areyou agraduateofaforeign medcatschoot seekingto performmedcat servcesinthe United States NO
but have notyetpassed the National Board ofMedicat Examiners examination or its equivatent2
Are you a health ca re worker seeking to perform such work in the United States but have not yet received NO
certification from the Commission on Graduates of Foreign Nursing Schools or from an equivalent
a pprov ed independent c redentia ling organization?
Are you permanently ineligible for U.S. citizenship? NO
Have you ever departed the United States in order to evade military service during a time of wa r? NO
Are you coming to the U.S. to practice poly gamy ? NO
Are you a former exchange visitor (3) who has not yet fulfil led the two-year foreign residence NO
requirement?
Has the Secretary of Homela nd Security of the United States ever determined that you knowingly made a NO
frivolous application for asy lum?
Are you likeIy to become a public c harge after you a re a dmitted to the United States ? NO
Onlin e Inn mig rant Vi sa and Ali en Regis trati on Application (D S-260)
YES
Do y ou autho riz e dis clos ure of inform at ion from this form t o the D ep art ment of Homel and Se curit y, YES
the Social Se curit y A dministration, and s uch other U .S. G o vemment a gen cies a s ma y be re quire d
for the purp ose s of as signing you a s o cial security numb er (SSN) and is s uing you a S o ci al Se curity
card and do you autho riz e the So cial Security Administrat ion t o s hare your SSN w ith the
D ep art ment of Homel and Se curit y?