Form DS-2003 NOTIFICATION OF APPOINTMENT OF FOREIGN DIPLOMATIC OFFICE

Foreign Diplomatic Services Applications (FDSA)

ds2003 - DRAFT - 11-21-2017

NOTIFICATION OF APPOINTMENT OF FOREIGN DIPLOMATIC OFFICER AND CAREER CONSULAR OFFICER

OMB: 1405-0105

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INSTRUCTIONS FOR COMPLETING FORM DS-2003,
NOTIFICATION OF APPOINTMENT OF FOREIGN DIPLOMATIC
OR CONSULAR OFFICER
Please read all instructions before completing this form.
This form is to be completed for all diplomatic and career consular officers of all foreign missions. All questions should be answered completely and
accurately. If a question does not apply, please type N/A.
Any changes in the information provided on this form should be reported as soon as possible using the Notification of Change, Form DS-2006.
NOTE: It is important that all information provided to the Office of Protocol and the Office of Foreign Missions be consistent. Discrepancies, such as in the
spelling of the name, the residence address, date of birth, etc., may delay processing applications for identification cards, tax exemption cards, drivers
licenses, and automobile registrations.

The instructions below are numbered to correspond to the numbered items on the form. PLEASE TYPE ALL ANSWERS.

1

Enter the name of the Embassy or Mission submitting the form.

9

Enter "X" in box indicating type of United States visa held in passport

Give telephone number and email address of office which can
be contacted for further information, if necessary.
10 Enter date (mm-dd-yyyy), of arrival in the United States and port of entry.
2

Enter an "X" in the box to indicate if the officer is a
DIPLOMATIC or CONSULAR officer. Enter and "X" to
indicate the type of office or mission to which the officer is
assigned.

3

Enter the officer's full name in the order specified: (a)
surname; (b) given name; (c) prefix such as Mr., Mrs., Ms., or
Miss, military rank, or title; (d) suffix, such as Jr. or Sr.; (e)
maiden name. Type "X" to indicate if male or female.

11 Enter residence address (not duty address unless actually living and
working at the same location), in the United States where officer currently
resides. If temporary (hotel, etc.), use Form DS-2006 to notify the Department
of State when officer moves to a permanent address.
12 Enter the name, address, and telephone number of foreign embassy,
mission or post where the officer will be assigned.

NOTE: The abbreviated name, if used, will appear in all
publications and documents issued by the U.S. Department of
State.
4

Enter present nationality.

5

Enter officer's date of birth (mm-dd-yyyy).

or annex where the officer will be working, if different from No. 12.

6

Enter nationality at birth, even if the same as No. 4.

7

Enter officer's place of birth - city and country or state.

NOTE: All addresses must be street addresses, including type, e.g. Street,
Ave., Blvd., etc., not post office box numbers, and must include ZIP codes and
telephone area codes.

8

Enter "X" in box indicating type of passport.

13 Enter the name, address, and telephone number of the actual office

14 Enter title of position, e.g. Minister (Political), Attache (Agriculture),
Third Secretary (Commercial), Consul General, etc. Enter "X" in box if
officer is the head of a post or mission or Deputy Head of Mission.
15 Enter the date (mm-dd-yyyy) officer assumed present official duties
in the United States.
16 Enter the date (mm-yyyy), (approximate) that officer will terminate
duties in the United States.
17 Enter name, title and Personal Identification Number (PID), if available,
of the person the officer is replacing. Enter date (mm-yyyy), of termination of
predecessor. If new position, so state.

DS-2003
11-2017

Instruction page 1 of 2

18

If officer will serve in any official capacity other than that
listed, such as a dual accreditation (e.g. diplomatic and consular
titles, diplomat at Embassy and O.A.S. or U.N.), enter position title
and mission. NOTE: Separate notification will be required.

19

If an immediate family member (spouse or dependent) is or
will be employed in the United States by a foreign government or
international organization, please identify and indicate position or title,
relationship and where the person is working. The person must be
notified separately to the Office of Protocol using the appropriate form.

20

If not listed in item 21, enter dates (mm-yyyy), nature and place
(city and state) of all previous assignments (including study and training)
in the United States. List To/From Month/Year (mm-yyyy).

21

Enter the dates (mm-yyyy), nature of employment (job title
and employer), and place (city and country) of academic study or other
activities for previous 5 years, starting from the most recent assignment
prior to this one. List to/From--Month/Year (mm-yyyy). (NOTE: For
Nos, 20, 21, attach additional sheet, if necessary.)

23 Enter "X" in appropriate boxes for an identification card.
Persons who should receive identification cards include: For diplomats
(a) principals. (b) spouses (except U.S. citizens), (c) dependents (except
U.S. citizens) who are unmarried children between 16 and 21 years who
reside with their parents or are full-time students, or unmarried children
under 23 years who are full-time students (for students between 21 and 23
attach family status justification form); for consular officers only the
consular officer, unless the sending state and the U.S. have a bilateral
agreement extending immunity to family members.
The officer must sign and date (mm-dd-yyyy), the form. The form must be
signed and dated (mm-dd-yyyy), by the designated approving embassy
official, and the official embassy seal must be affixed.

22 Enter names of all family members residing in the household
in the United States, following the same format as in NO. 3 above.
Use Form DS-2007 for additional names. Give date of birth
(mm-dd-yyyy), place of birth, (city country), current citizenship, and
relationship to principle employee. Enter type of United States visa
(A-1, B-2, etc.) currently held.

Submit forms and attachments to
U.S. Department of State
3507 International Place, NW
Washington, DC 20008-3034

ANY CHANGES IN THE INFORMATION PROVIDED ON THIS FORM SHOULD BE REPORTED AS SOON AS POSSIBLE
USING NOTIFICATION OF CHANGE, FORM DS-2006.
DS-2003

Instruction page 2 of 2

OMB APPROVAL NO. 1405-0105
EXPIRATION DATE: XX-XX-20XX
ESTIMATED BURDEN: 25 MINUTES*

U.S. Department of State

FOR OFFICIAL USE ONLY
P

NOTIFICATION OF APPOINTMENT
OF FOREIGN DIPLOMATIC OFFICER
AND CAREER CONSULAR OFFICER

R

A

T

TO: Secretary of State, Attention - Department of State

PID

Recognition Date (mm-dd-yyyy)

1. From (Name of Embassy/Mission)

2. Type of Officer
Embassy

Diplomatic

Consular

Mission To International Organization

World Bank

International Monetary Fund

Other
Contact Name, Telephone Number and Email Address

3. Full Name
(a) Surname (Last)

(c)Prefix or Rank

(b) Given Name

(d) Suffix

(e) Maiden
Male

4. Current Citizenship

5. Date of Birth (mm-dd-yyyy)

6. Citizenship at Birth

7. Place of Birth (City, Country)

8. Type of Passport

9. Type of VISA

Diplomatic

Official

Regular

Other

10.Last Arrival in U.S.A.

Other

G1

G2

G3

Number
Port of Entry

G4

(Specify type)

Temporary

Permanent
Apt.

Street (Ave., Blvd., Place, Etc.)

City

State

Zip

Telephone
13. Duty Office (If different from employing office)

12.Employing Office

Name of Office

Name of Office
Suite

Street (Ave., Blvd., Place, Etc.)

City

State

Telephone
14. Job Title

Zip

Ext.

Deputy Head of
Head of
Yes
No
Mission?
Mission?
16. Expected Date of Departure (mm-yyyy)

Yes

18.Will Officer Serve in Another Official Capacity?
Yes

A2

11. Residence Address

Date (mm-dd-yyyy)

Number

A1

Female

No

If Yes, give position and duty office:

Number

Suite

Street (Ave., Blvd., Place, Etc.)
State

City
Telephone
15. Date of Entry on Duty (mm-dd-yyyy)

ZIP

Ext.

No
17. Name, Title and PID (If available) of Predecessor and Date (mm-yyyy)
of Termination

19. Are There Any Immediate Family Members Employed By A Foreign
Government in The United States?
Yes

No

If Yes, give names and duty office:

Each person must submit a separate notification of appointment.
DS-2003
11-2017

Page 1 of 2

20. All previous assignments within the United States (If not listed in item 21 below, including study and training)
(List To/From (mm-yyyy))

21. All assignments/positions/academic studies/other activities within past five years (Dates, nature of activity, and location beginning with most recent) (List To/From (mm-yyyy))

22. Family Members Residing in household in the United States (Use DS-2007 continuation sheet if necessary; Staple to this form)
(a) Surname (Last)
(c) Prefix

(b) Given Name

(d) Suffix

(e) Maiden

(f) Other

(g) Relationship
Male

Date of Birth (mm-dd-yyyy)

Place of Birth (City, Country)

Citizenship

Female

VISA Status (Attach copies)

23. Please indicate if requesting identification cards for dependent:
Yes

No
Intentional provision of false information on this form violates United States law (Title 18 U.S. Code, Section
1001) and will be considered a violation of the international legal obligation of foreign missions and their
personnel to respect the laws of the receiving state (Vienna Convention on Diplomatic Relations, 1961, Article
41; Vienna Convention on Consular Relations, 1963, Article 55).
ANY CHANGES IN THIS INFORMATION MUST BE REPORTED IMMEDIATELY
TO THE DEPARTMENT OF STATE (USE FORM DS-2006, NOTIFICATION OF
CHANGE)
Signature of Applicant

Date
(mm-dd-yyyy)
(Embassy Seal)

Chief of Mission or Authorized Deputy

Signature of Chief of Mission or Authorized Deputy

Date
(mm-dd-yyyy)

PRIVACY ACT and PAPERWORK REDUCTION ACT STATEMENTS
The Privacy Act of 1974, as amended, 5 U.S.C. 552a, contains provisions regarding the maintenance, collection, use, and dissemination of information about United States
citizens and aliens lawfully admitted for permanent residence in the United States. The following information is provided in accordance with subsection (e)(3) of the Privacy
Act.
AUTHORITIES: The information is sought pursuant to Vienna Convention on Diplomatic Relations of 1961; Vienna Convention on Consular Relations of 1963; Diplomatic
Relations Act (22 U.S.C. 254a-e); and International Organizations Immunities Act (22 U.S.C. 288e (a)).
PURPOSE: The principal purpose for the collection of this information is to notify the U.S. Department of State of the appointment of foreign diplomatic officers or career
consular officers so the Department can therefore extend various privileges and benefits granted by the above-cited authorities which are predicated upon review and
acceptance of this information by the U.S. Department of State.
ROUTINE USES: The principal users of this information are offices within the U.S. Department of State, including but not limited to, the Office of Protocol, the Office of
Foreign Missions, and the Office of Visa Services. In response to inquiries from law enforcement agencies, the Office of Protocol may confirm status as recognized by the
U.S. Department of State as covered under STATE 36, Security Records. Information may also be provided to other government agencies having statutory or other lawful
authority to maintain such information. Names of the members of diplomatic staff, office addresses, titles, and names of spouses are published quarterly in the Diplomatic
List, U.S. Department of State Publication 10424. Names of Consular Officers, titles, and office addresses are published semi-annually in Foreign Consular Offices in the
United States, U.S. Department of State Publication 10277.
DISCLOSURE: Providing this information is mandatory. Failure to provide the information requested on this form may prevent acceptance and the extension of benefits to
*Public reporting burden for this collection of information is estimated to average 25 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: M/OFM, 3507 International Place NW, Washington, DC 20008.

DS-2003

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File Typeapplication/pdf
File TitleDS-2003
SubjectNotice of Appointment of Foreign Diplomatic Officer and Career Consular Officer (Formerly DSP-110)
File Modified0000-00-00
File Created0000-00-00

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