Fictional example · DS-160 · Child travelling with parents

B1/B2 DS-160 Sample for a Child (Brazil)

See how a fictional 10-year-old from Brazil travelling with both parents answered the DS-160, including his school, who pays, and his father helping as the form's preparer. Know what the form asks before you start your child's.

18sections168responses~25 minto fillDS-160s for children
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This is a fictional example for educational purposes, not an official or pre-approved application. Your DS-160 answers must reflect your own circumstances. Do not copy the sample answers unless they are independently true for you.

Is this example similar to your situation?

  • B1/B2 visitor visa for a child, applying in São Paulo
  • 10 years old, on a two-week family holiday in Florida with both parents
  • His father pays for the trip and filled in the form for him
  • A primary school student, with no income
  • No individual U.S. contact: the resort they are staying at is given instead
  • First trip to the U.S.

Different situation? Browse other completed DS-160 examplesSkip to the full sample

Before you start: information you'll want ready

The form will ask for

  • Your child's passport
  • Your child's school name and address
  • Both parents' full names and dates of birth
  • The details of whoever pays for the trip
  • The details of the parent filling in the form, as the preparer
  • Where you will stay in the U.S.

Helpful to have nearby

  • The names of everyone travelling with your child, to list as companions
  • A recent photo of your child that meets the U.S. visa photo rules

Questions applicants commonly get stuck on

How this fictional applicant answered, why, and what to check for your own form. Answer for your own situation, which may differ.

  1. Sample answer

    Preparer of Application

    If someone other than you completed this application, provide their details here. You must still electronically sign the application yourself.

    Did anyone assist you in filling out this application?
    Preparer Details
    NA Does Not Apply
    NA Does Not Apply
    NA Does Not Apply
    NA Does Not Apply
    NA Does Not Apply
    Why
    Lucas is 10, so his father filled in the form for him and gives his own details as the preparer.
    For your application
    If anyone helps fill in the form, answer Yes and give their details. If you fill it in yourself, answer No.

  2. Sample answer

    Present Work/Education/Training Information
    Present Employer or School Information
    Present Employer or School Address
    NA Does not apply
    NA Does not apply
    Start Daterequired
    08 FEB 2022
    NA Does not apply
    Why
    Lucas is in primary school, so he chooses Student, names his school, and has no income to give.
    For your application
    For a child at school, choose Student and give the school. Leave income as Does not apply if there is none.

  3. Sample answer

    Contact Person or Organization in the United States

    Your U.S. Point of Contact can be any individual in the U.S. who knows you and can verify, if necessary, your identity. If you do not personally know anyone in the U.S., you may enter the name of the store, company, or organization you plan to visit during your trip.

    Contact Person or Organization in the United States

    Contact Person

    Do Not Know

    Organization Name

    Do Not Know
    Why
    The family has no individual contact in the U.S., so they give the resort where they will stay instead.
    For your application
    If you know nobody in the U.S., you can name an organisation, such as the hotel where you will stay.

  4. Sample answer

    Phone

    You must provide a primary phone number. The primary phone number should be the phone number at which you are most likely to be reached; this could be a land line or a cellular/mobile number. If you have an additional land line or a cellular/mobile number please list that as your secondary phone number.

    Phone
    NA Does not apply
    NA Does not apply

    Email Address

    You must provide an email address. The email address you provide will be used for correspondence purposes. Provide an email address that is secure and to which you have reasonable access.

    Why
    Lucas has no phone or email of his own, so his father's are given.
    For your application
    A child can give a parent's phone and email, as long as they reach the family.

  5. Sample answer

    Social Media
    Why
    Lucas has no social media accounts, so None is chosen.
    For your application
    Choose None only if the applicant has no accounts. Otherwise list each platform and username used in the last five years.

  6. Sample answer

    Traveling with Others

    You should answer Yes to this question if you are traveling with family, as part of an organized tour, or as part of a performing group or athletic team. You do not need to list individuals who are traveling with you for the purposes of employment with the same employer.

    Are there other persons traveling with you?required
    Are you traveling as part of a group or organization?required
    Provide the following information for each person traveling with you:
    Why
    Both parents travel with him, so they are listed as companions. Each parent fills in their own DS-160.
    For your application
    List everyone travelling with your child. Each of them needs their own DS-160.

Common questions about this example

Does my child need their own DS-160?

Yes. Every applicant, children included, needs their own DS-160 and confirmation number.

Official source
Who fills in and signs a child's DS-160?

A parent can fill it in and is named on the preparer page, as Lucas's father is here. Check the official DS-160 FAQs for how a child's application is signed.

Official source
What do I enter for my child's occupation?

Choose Student and give the school's name and address. A child with no income leaves monthly income as Does not apply.

Can I use my own phone and email for my child?

Yes, if they are how to reach your child, as Lucas's father does in this example.

The completed DS-160, question by question

§1

Personal Information - Part 1

11 responses

Surnames

Enter all surnames as listed in your passport. If only one name is listed in your passport, enter that Surname.

Given Names

If your passport does not include a given name, please enter 'FNU' in Given Names.

Full Name in Native Alphabet

If your passport does not include a given name, please enter 'FNU' in Given Names.

NA Does Not Apply/Technology Not Available

Other Names

Other names used include your maiden name, religious name, professional name, or any other names which you are known by or have been known by in the past.

Have you ever used other names (i.e., maiden, religious, professional, alias, etc.)?required

Telecode

Telecodes are 4 digit code numbers that represent characters in some non-Roman alphabet names.

Do you have a telecode that represents your name?required

Sex

Please select MALE or FEMALE

Date of Birth

If day or month is unknown, enter as shown in passport.

Date of Birthrequired
29 JUL 2016
NA Does Not Apply

Country/Region

Select the name that is currently in use for the place where you were born.

§2

Personal Information - Part 2

6 responses
Do you hold or have you held any nationality other than the one indicated above on nationality?required

Permanent Resident

Permanent resident means any individual who has been legally granted by a country/region permission to live and work without time limitation in that country/region.

Are you a permanent resident of a country/region other than your country/region of origin (nationality) indicated above?required

Identification Numbers

Your National ID Number is a unique number that your government provides. The U.S. Government provides unique numbers to those who seek employment (Social Security Number) or pay taxes (Taxpayer ID).

NA Does Not Apply
NA Does Not Apply
NA Does Not Apply
§3

Purpose of Visa

28 responses
Purpose of Visit
Have you made specific travel plans?required
Provide a complete itinerary for your travel to the U.S.

Travel Plans

If you are unsure of your Date of Arrival in U.S. or Date of Departure from U.S., please provide an estimate.

Arrival Daterequired
15 JAN 2027
Departure Daterequired
29 JAN 2027
Locations you plan to visit in the USA:
Address where you will stay in the U.S.
Provide the following information:
NA Does Not Apply
Is the address of the party paying for your trip the same as your Home or Mailing Address?required
Address of Person Paying
NA Does Not Apply
NA Does Not Apply
§4

Travel Companions

8 responses

Traveling with Others

You should answer Yes to this question if you are traveling with family, as part of an organized tour, or as part of a performing group or athletic team. You do not need to list individuals who are traveling with you for the purposes of employment with the same employer.

Are there other persons traveling with you?required
Are you traveling as part of a group or organization?required
Provide the following information for each person traveling with you:
§5

Previous U.S. Travel History

5 responses
Have you ever been in the U.S.?required
Have you ever been issued a U.S. Visa?required
Have you ever been refused a U.S. Visa, or been refused admission to the United States, or withdrawn your application for admission at the port of entry?required
Have you ever been denied travel authorization by the Department of Homeland Security through the Electronic System for Travel Authorization (ESTA)?required
Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and Immigration Services?required
§6

Address and Phone Details

16 responses
Home Address
NA Does not apply
NA Does not apply

Mailing Address

If your mailing address is different from your home address, please provide your mailing address.

Is your Mailing Address the same as your Home Address?required

Phone

You must provide a primary phone number. The primary phone number should be the phone number at which you are most likely to be reached; this could be a land line or a cellular/mobile number. If you have an additional land line or a cellular/mobile number please list that as your secondary phone number.

Phone
NA Does not apply
NA Does not apply
Have you used any other phone numbers in the last five years?required

Email Address

You must provide an email address. The email address you provide will be used for correspondence purposes. Provide an email address that is secure and to which you have reasonable access.

Have you used any other email addresses in the last five years?required
Social Media
Do you wish to provide information about your presence on any other websites or applications you have used within the last five years to create or share content (photos, videos, status updates, etc.)?required
§7

Passport Information

10 responses

Passport/Travel Document Number

Enter the information on the travel document you will be using when traveling to the U.S. Your travel document should be a valid, unexpired passport or other valid, unexpired documentation that is sufficient to establish your identity and nationality.

Passport Book Number

The Passport Book Number is commonly called the inventory control number. You may or may not have a Passport Book Number on your passport. The location of the Passport Book Number on your passport may vary depending on the country that issued your passport. Please contact your passport issuing authority if you are unable to determine whether or not your passport contains a Passport Book Number.

NA Does not apply
Where was the Passport/Travel Document Issued?
Issuance Daterequired
21 APR 2025

Expiration Date

In most cases your passport/Travel Document must have at least six months of validity beyond the date of your visa application and/or your arrival in the United States.

Expiration Daterequired
20 APR 2030
NA No expiration
Have you ever lost a passport or had one stolen?required
§8

US Contact Information

10 responses

Contact Person or Organization in the United States

Your U.S. Point of Contact can be any individual in the U.S. who knows you and can verify, if necessary, your identity. If you do not personally know anyone in the U.S., you may enter the name of the store, company, or organization you plan to visit during your trip.

Contact Person or Organization in the United States

Contact Person

Do Not Know

Organization Name

Do Not Know
Address and Phone Number of Point of Contact
NA Does not apply
§9

Family Information

10 responses
Father's Full Name and Date of Birth
NA Do not know
NA Do not know
Date of Birthrequired
12 NOV 1984
NA Do not know
Is your father in the U.S.?required
Mother's Full Name and Date of Birth
NA Do not know
NA Do not know
Date of Birthrequired
24 MAR 1987
NA Do not know
Is your mother in the U.S.?required

Immediate Relatives

Means fiancé/fiancée, spouse (husband/wife), child (son/daughter), or sibling (brother/sister).

Do you have any immediate relatives, not including parents, in the United States?required
Do you have any other relatives in the United States?required
§10

Current Occupation

12 responses
Present Work/Education/Training Information
Present Employer or School Information
Present Employer or School Address
NA Does not apply
NA Does not apply
Start Daterequired
08 FEB 2022
NA Does not apply
§11

Previous Occupation

2 responses
Were you previously employed?required

Level of Education

You must answer Yes to this question if you have ever attended, for any length of time, a high school/secondary school (or its equivalent in your country) or college, university, graduate school, a doctoral program, or a vocational program.

Have you attended any educational institutions at a secondary level or above?required
§12

Additional Occupation Details

8 responses
Do you belong to a clan or tribe?required
Provide a List of Languages You Speak

Enter only one language per field. To add more languages, use the Add Another button below — do not list several languages in the same field.

Have you traveled to any countries/regions within the last five years?required
Provide a List of Countries/Regions Visited
Have you belonged to, contributed to, or worked for any professional, social, or charitable organization?required
Do you have any specialized skills or training, such as firearms, explosives, nuclear, biological, or chemical experience?required
Have you ever served in the military?required
Have you ever served in, been a member of, or been involved with a paramilitary unit, vigilante unit, rebel group, guerrilla group, or insurgent organization?required
§13

Security Background - Part 1

3 responses
Do you have a communicable disease of public health significance? (Communicable diseases of public significance include chancroid, gonorrhea, granuloma inguinale, infectious leprosy, lymphogranuloma venereum, infectious stage syphilis, active tuberculosis, and other diseases as determined by the Department of Health and Human Services.)required
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?required
Are you or have you ever been a drug abuser or addict?required
§14

Security Background - Part 2

7 responses
Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty, or other similar action?required
Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substances?required
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?required
Have you ever been involved in, or do you seek to engage in, money laundering?required
Have you ever committed or conspired to commit a human trafficking offense in the United States or outside the United States?required
Have you ever knowingly aided, abetted, assisted or colluded with an individual who has committed, or conspired to commit a severe human trafficking offense in the United States or outside the United States?required
Are you the spouse, son, or daughter of an individual who has committed or conspired to commit a human trafficking offense in the United States or outside the United States and have you within the last five years, knowingly benefited from the trafficking activities?required
§15

Security Background - Part 3

12 responses
Do you seek to engage in espionage, sabotage, export control violations, or any other illegal activity while in the United States?required
Do you seek to engage in terrorist activities while in the United States or have you ever engaged in terrorist activities?required
Have you ever or do you intend to provide financial assistance or other support to terrorists or terrorist organizations?required
Are you a member or representative of a terrorist organization?required
Are you the spouse, son, or daughter of an individual who has engaged in terrorist activity, including providing financial assistance or other support to terrorists or terrorist organizations, in the last five years?required
Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide?required
Have you ever committed, ordered, incited, assisted, or otherwise participated in torture?required
Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings, political killings, or other acts of violence?required
Have you ever engaged in the recruitment or the use of child soldiers?required
Have you, while serving as a government official, been responsible for or directly carried out, at any time, particularly severe violations of religious freedom?required
Have you ever been directly involved in the establishment or enforcement of population controls forcing a woman to undergo an abortion against her free choice or a man or a woman to undergo sterilization against his or her free will?required
Have you ever been directly involved in the coercive transplantation of human organs or bodily tissue?required
§16

Security Background - Part 4

5 responses
Have you ever been the subject of a removal or deportation hearing?required
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?required
Have you failed to attend a hearing on removability or inadmissibility within the last five years?required
Have you ever been unlawfully present, overstayed the amount of time granted by an immigration official or otherwise violated the terms of a U.S. visa?required
Have you ever been removed or deported from any country?required
§17

Security Background - Part 5

5 responses
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?required
Have you voted in the United States in violation of any law or regulation?required
Have you ever renounced United States citizenship for the purposes of avoiding taxation?required
Are you a former exchange visitor (J) who has not yet fulfilled the two-year foreign residence requirement?required
Have you attended a public elementary school on student (F) status or a public secondary school after November 30, 1996 without reimbursing the school?required
§18

Preparer of Application

10 responses

Preparer of Application

If someone other than you completed this application, provide their details here. You must still electronically sign the application yourself.

Did anyone assist you in filling out this application?
Preparer Details
NA Does Not Apply
NA Does Not Apply
NA Does Not Apply
NA Does Not Apply
NA Does Not Apply

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