DS-1648 Application for A, G, or NATO Visa

Approved OMB 1405-0100
Expiration Date: 12-31-2006
Estimated Burden 30 minutes

U.S. Department of State

APPLICATION FOR A, G, OR NATO VISA
1. Passport Type
Diplomatic

PLEASE TYPE OR PRINT YOUR ANSWERS IN THE SPACE PROVIDED BELOW EACH ITEM
DO NOT WRITE IN THIS SPACE
4. Passport Place of Issuance:
3. Passport Issuing
2. Passport Number
Country
City
Country
Visa Classification

Official
Regular

6. Passport Expiration Date (dd-mmm-yyyy) 7. Current Visa Status

5. Passport Issuance Date (dd-mmm-yyyy)

Multiple or
Entries

8. Surnames (As in Passport)

Validity
Issued/Refused On

9. First and Middle Names (As in Passport)

By

11. Place of Birth:
City

10. Date of Birth (dd-mmm-yyyy)

13. Sex

12. Nationality
Country

14. Marital Status (Check one)
Male
Widowed

Single

Married

Female

Divorced

Legally Separated

15. Home Address (Include apartment number, street, city, state, zip code)

16. Home Telephone Number

(

17. Telephone Number (Mission/Organization)

(

)

18. Personal Identification Number (PID)

)

19. Relationship to Principal Applicant
Spouse

Child

Parent

Household Employee

Other

20. Name and PID of Principal Alien

21. Estimated Date of Completion of Tour/Employment (dd-mmm-yyyy)

22 Travel Date (dd-mmm-yyyy)

23. Sponsoring Embassy/Consulate/ Organization

24. Address of Embassy/Organization

DO NOT WRITE IN THIS SPACE

EMBASSY/ORGANIZATION SEAL
50 mm x 50 mm
PHOTO
Signature of Applicant

staple or glue photo here

Date (dd-mmm-yyyy)
TYPED NAME OF PERSON PREPARING FORM
*Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time required for searching existing data
sources, gathering the necessary data, providing the information required, and reviewing the final collection. 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.

DS-1648
12-2003