Consular Electronic Application Center - Print Application

Online Nonimmigrant Visa Application (DS-160)

Application - Sensitive But Unclassified(SBU)

We do not need a printed copy of your application at any point during your interview process. Only print this application if you want a copy for your own records. If you print your application, please keep it secure.

Photo Provided:
Confirmation Number:
Your Personal Copy -- Do Not Bring to Interview

Personal, Address, Phone, and Passport/Travel Document Information
Name Provided:
JOHNSON, ALEXANDER BORIS DE PFEFFEL
Full Name in Native Language:
DOES NOT APPLY
Other Names Used:
YES
Other Name (1):
JOHNSON, BORIS
Telecode Name Used:
NO
Sex:
MALE
Marital Status:
MARRIED
Date of Birth:
19 JUNE 1964
Place of Birth:
NEW YORK, NEW YORK, UNITED STATES OF AMERICA
Country/Region of Origin (Nationality):
UNITED KINGDOM
Do you hold or have you held any nationality other than the one indicated above on nationality?
YES
Other Country/Region of Origin (Nationality) (1):
UNITED STATES OF AMERICA
Do you hold a passport for the other country/region of origin (nationality) above?
NO
Are you a permanent resident of a country/region other than your country/region of origin (nationality) above?
NO
National Identification Number:
JA 05 76 99 D
U.S. Social Security Number:
922764448
U.S. Taxpayer ID Number:
DOES NOT APPLY
Home Address:
BRIGHTWELL MANOR
BRIGHTWELL-CUM-SOTWELL
City:
WALLINGFORD
State/Province:
OXFORDSHIRE
Postal Zone/ZIP Code:
OX10 0RT
Country/Region:
UNITED KINGDOM
Same Mailing Address?
NO
Mailing Address:
27 PANBRO HOUSE
GILBERT CLOSE
City:
LONDON
State/Province:
DOES NOT APPLY
Postal Zone/ZIP Code:
SE18 4PS
Country/Region:
UNITED KINGDOM
Primary Phone Number:
07552441860
Secondary Phone Number:
DOES NOT APPLY
Work Phone Number:
DOES NOT APPLY
Do you have any additional phone numbers?
NO
Email Address:
alexanderbj64@googlemail.com
Do you have any additional email addresses?
NO
Do you have a social media presence?
Social Media Platform: (1):
Facebook
Social Media Identifier:
BORIS JOHNSON
Social Media Platform: (2):
Instagram
Social Media Identifier:
@BORISJOHNSONUK
Social Media Platform: (3):
LinkedIn
Social Media Identifier:
BORIS JOHNSON
Social Media Platform: (4):
Twitter/X
Social Media Identifier:
@BORIS JOHNSON
Do you have any additional social media presence?
NO
Passport/Travel Document Type:
REGULAR
Passport/Travel Document Number:
120685847
Passport Book Number:
DOES NOT APPLY
Country/Authority that Issued Passport/Travel Document:
UNITED KINGDOM
City Where Issued:
HMPO
Country/Region Where Issued:
UNITED KINGDOM
Issuance Date:
26 MARCH 2021
Expiration Date:
26 MARCH 2031
Have you ever lost a passport or had one stolen?
NO

Travel Information
The List of Purposes of Trip to the U.S.
Purpose of Trip to the U.S. (1):
ALIEN WITH EXTRAORDINARY ABILITY (O)
Specify:
EXTRAORDINARY ABILITY (O1)
Application Receipt/Petition Number:
SRC2409350377
Have you made specific travel plans?
YES
Provide a complete itinerary for your travel to the U.S.:
Date of Arrival in U.S.:
02 MARCH 2024
Arrival Flight:
BA1590
Arrival City:
DALLAS FT WORTH
Date of Departure from U.S.:
04 MARCH 2024
Departure Flight:
BA5661
Departure City:
SALT LAKE CITY
The Location(s) you plan to visit in the U.S.
Location (1):
UTAH
Address where you will stay in the U.S.:
2250 DEER VALLEY DR S
City, State, Postal/Zip Code:
PARK CITY, UTAH 84060
Person/Entity Paying for Your Trip:
U.S. PETITIONER
Are there other persons traveling with you?
YES
Are you traveling as part of a group or organization?
NO
Persons Traveling with You:
Name (1):
WILLIAMS WALKER, MICHELLE
Relationship to You:
BUSINESS ASSOCIATE
Have you ever been in the U.S.?
YES
Date Arrived (1):
08 NOVEMBER 2023
Length of Stay:
3 DAY(S)
Date Arrived (2):
04 OCTOBER 2023
Length of Stay:
3 DAY(S)
Date Arrived (3):
21 MAY 2023
Length of Stay:
5 DAY(S)
Date Arrived (4):
10 APRIL 2023
Length of Stay:
9 DAY(S)
Date Arrived (5):
30 JANUARY 2023
Length of Stay:
4 DAY(S)
Do you or did you hold a U.S. Driver's License?
NO
Have you ever been issued a U.S. Visa?
YES
Date Last Visa was Issued:
04 OCTOBER 2022
Visa Number:
R5001237
Are you applying for the same type of visa?
YES
Are you applying in the same country where the visa above is issued and is this country your principal country of residence?
YES
Have you been ten-printed?
YES
Has your U.S. Visa ever been lost or stolen?
NO
Has your U.S. Visa ever been cancelled or revoked?
NO
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?
NO
Have you ever been denied travel authorization by the Department of Homeland Security through the Electronic System for Travel Authorization (ESTA)?
NO
Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and Immigration Services?
NO
U.S. Contact Information
Contact Person Name in the U.S.:
DO NOT KNOW
Organization Name in the U.S.:
HARRY WALKER AGENCY LLC
Relationship to You:
U.S. PETITIONER
Family Information
Father's Surnames:
JOHNSON
Father's Given Names:
STANLEY PATRICK
Father's Date of Birth:
18 AUGUST 1940
Is your father in the U.S.?
NO
Mother's Surnames:
JOHNSON WAHL
Mother's Given Names:
CHARLOTTE
Mother's Date of Birth:
29 MAY 1942
Is your mother in the U.S.?
NO
Do you have any immediate relatives, not including parents in the U.S.?
NO
Do you have any other relatives in the United States?
NO
Spouse's Full Name:
SYMONDS, CAROLINE LOUISE BEVAN
Spouse's Date of Birth:
17 MARCH 1988
Spouse's Country/Region of Origin (Nationality):
UNITED KINGDOM
Spouse's City of Birth:
LONDON
Spouse's Country/Region of Birth:
UNITED KINGDOM
Spouse’s Address:
SAME AS HOME ADDRESS
Work/Education/Training Information
Primary Occupation:
OTHER
Specify Other:
GLOBAL AND POLITICAL AFFAIRS E
XPERT
Present Employer or School Name:
SELF EMPLOYED
Address:
BRIGHTWELL MANOR
BRIGHTWELL-CUM-SOTWELL
City:
WALLINGFORD
State/Province:
OXFORDSHIRE
Postal Zone/Zip Code:
OX10 ORT
Country/Region:
UNITED KINGDOM
Work Phone Number:
07904286145
Monthly Salary in Local Currency (if employed):
DOES NOT APPLY
Briefly Describe your Duties:
GLOBAL AND POLITICAL AFFAIRS E
XPERT
Were you previously employed?
YES
Employer Name (1):
CABINET OFFICE
Employer Address:
70 WHITEHALL
City:
LONDON
State/Province:
DOES NOT APPLY
Postal Zone/Zip Code:
SW1A 2AS
Country/Region:
UNITED KINGDOM
Telephone Number:
00000
Job Title:
PRIME MINISTER
Supervisor's Surname:
NOT
Supervisor's Given Name:
APPLICABLE
Employment Date From:
JULY 2019
Employment Date To:
SEPTEMBER 2022
Briefly describe your duties:
PRIME MINISTER OF THE UK.
Employer Name (2):
HOUSE OF COMMONS
Employer Address:
HOUSE OF COMMONS
City:
LONDON
State/Province:
DOES NOT APPLY
Postal Zone/Zip Code:
SW1A 0AA
Country/Region:
UNITED KINGDOM
Telephone Number:
07904286145
Job Title:
MEMBER OF PARLIAMENT
Supervisor's Surname:
DO NOT KNOW
Supervisor's Given Name:
DO NOT KNOW
Employment Date From:
07 SEPTEMBER 2022
Employment Date To:
12 JUNE 2023
Briefly describe your duties:
MEMBER OF PARLIAMENT FOR THE C
ONSTITUENCY OF UXBRIDGE AND SO
UTH RUISLIP
Have you attended any educational institutions at a secondary level or above?
YES
Name of Institution (1):
ASHDOWN HOUSE
Address of Institution:
FOREST ROW
City:
EAST SUSSEX
State/Province:
DOES NOT APPLY
Postal Zone/ZIP Code:
DOES NOT APPLY
Country/Region:
UNITED KINGDOM
Course of Study:
SECONDARY EDUCATION
Date of Attendance From:
SEPTEMBER 1976
Date of Attendance To:
JULY 1977
Name of Institution (2):
ETON
Address of Institution:
WINDSOR
City:
BERKSHIRE
State/Province:
DOES NOT APPLY
Postal Zone/ZIP Code:
SL4 6DW
Country/Region:
UNITED KINGDOM
Course of Study:
SECONDARY EDUCATION
Date of Attendance From:
SEPTEMBER 1977
Date of Attendance To:
JULY 1982
Name of Institution (3):
BALLIOL COLLEGE
Address of Institution:
OXFORD
City:
OXFORD
State/Province:
DOES NOT APPLY
Postal Zone/ZIP Code:
OX1 3BJ
Country/Region:
UNITED KINGDOM
Course of Study:
LITERAI HUMANIORES
Date of Attendance From:
SEPTEMBER 1983
Date of Attendance To:
JULY 1987
Do you belong to a clan or tribe?
NO
Provide a List of Languages You Speak:
Language Name (1):
ENGLISH
Language Name (2):
FRENCH
Have you traveled to any countries/regions within the last five years?
YES
Provide a List of Countries/Regions Visited
Country/Region (1):
BELGIUM
Country/Region (2):
CYPRUS
Country/Region (3):
ESTONIA
Country/Region (4):
FINLAND
Country/Region (5):
FRANCE
Country/Region (6):
GERMANY
Country/Region (7):
GREECE
Country/Region (8):
IRELAND
Country/Region (9):
ITALY
Country/Region (10):
LATVIA
Country/Region (11):
MALTA
Country/Region (12):
POLAND
Country/Region (13):
RUSSIA
Country/Region (14):
SLOVAKIA
Country/Region (15):
SPAIN
Country/Region (16):
SWEDEN
Country/Region (17):
NETHERLANDS
Country/Region (18):
UKRAINE
Country/Region (19):
BANGLADESH
Country/Region (20):
INDIA
Country/Region (21):
INDONESIA
Country/Region (22):
IRAN
Country/Region (23):
JAPAN
Country/Region (24):
MALAYSIA
Country/Region (25):
BURMA
Country/Region (26):
OMAN
Country/Region (27):
SAUDI ARABIA
Country/Region (28):
THAILAND
Country/Region (29):
CHILE
Country/Region (30):
UNITED ARAB EMIRATES
Country/Region (31):
UNITED STATES OF AMERICA
Country/Region (32):
ARGENTINA
Country/Region (33):
PERU
Country/Region (34):
ETHIOPIA
Country/Region (35):
GHANA
Country/Region (36):
KENYA
Country/Region (37):
LIBYA
Country/Region (38):
NIGERIA
Country/Region (39):
RWANDA
Country/Region (40):
SENEGAL
Country/Region (41):
TUNISIA
Country/Region (42):
QATAR
Country/Region (43):
IRAQ
Country/Region (44):
BRAZIL
Country/Region (45):
PORTUGAL
Country/Region (46):
AUSTRALIA
Country/Region (47):
CANADA
Country/Region (48):
KOREA, REPUBLIC OF (SOUTH)
Have you belonged to, contributed to, or worked for any professional, social, or charitable organization?
NO
Do you have any specialized skills or training, such as firearms, explosives, nuclear, biological, or chemical experience?
NO
Have you ever served in the military?
NO
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?
NO
Security and Background Information
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 others diseases as determined by the Department of Health and Human Services.)
NO
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?
NO
Are you or have you ever been a drug abuser or addict?
NO
Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty, or other similar action?
NO
Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substances?
NO
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?
NO
Have you ever been involved in, or do you seek to engage in, money laundering?
NO
Have you ever committed or conspired to commit a human trafficking offense in the United States or outside the United States?
NO
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?
NO
Have you 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?
NO
Do you seek to engage in espionage, sabotage, export control violations, or any other illegal activity while in the United States?
NO
Do you seek to engage in terrorist activities while in the United States or have you ever engaged in terrorist activities?
NO
Have you ever or do you intend to provide financial assistance or other support to terrorists or terrorist organizations?
NO
Are you a member or representative of a terrorist organization?
NO
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?
NO
Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide?
NO
Have you ever committed, ordered, incited, assisted, or otherwise participated in torture?
NO
Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings, political killings, or other acts of violence?
NO
Have you ever engaged in the recruitment or the use of the child soldiers?
NO
Have you, while serving as a government official, been responsible for or directly carried out, at any time, particularly severe violations of religious freedom?
NO
Have you ever been directly involved in the establishment or enforcement of the 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?
NO
Have you ever been directly involved in the coercive transplantation of human organs or bodily tissue?
NO
Have you ever been the subject of a removal or deportation hearing?
NO
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?
NO
Have you failed to attend a hearing on removability or inadmissibility within the last five years?
NO
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?
NO
Have you ever been removed or deported from any country?
NO
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?
NO
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 on student (F) status or a public secondary school after November 30, 1996 without reimbursing the school?
NO
Temporary Work Visa Information
Application Receipt/Petition Number:
SRC2409350377
Name of Person/Company who Filed Petition:
HARRIS WALKER AGENCY LLC
Where Do You Intend to Work?
Name of Employer:
HARRIS WALKER AGENCY LLC
Street Address:
MULTIPLE LOCATIONS
THROUGHOUT THE US, NEW YORK
Phone Number:
2026624420
Monthly Income (in USD):
$115,000
Location Information
Location where you will be submitting your application
Current Location:
LONDON, ENGLAND
Preparer of Application
Did anyone assist you in filling out this application?
YES
Preparer Surnames:
JACKSON
Preparer Given Names:
CHRISTI
Organization Name:
LAURA DEVINE IMMIGRATION
Street Address:
100 CANNON STREET
FLOOR 6
City:
LONDON
State/Province:
DOES NOT APPLY
Postal Zone/ZIP Code:
EC4N 6EU
Country/Region:
UNITED KINGDOM
Relationship to You:
ATTORNEY
Your Personal Copy -- Do Not Bring to Interview
You electronically signed your application on 28-Feb-2024 10:56:29 (GMT-05:00). You were required to electronically sign your application yourself, unless otherwise exempt by regulation, even if the application was prepared by someone other than yourself. Your electronic signature certifies that you have read and understood the questions in this application and that your answers are true and correct to the best of your knowledge and belief. The submission of an application containing any false or misleading statements may result in the permanent refusal of a visa or the denial of entry into the United States. All declarations made in this application are unsworn declarations made under penalty of perjury. (28 U.S.C. 1746).

You certified that you understand that you are required to submit your visa to the United States Immigration Officer at the port where you apply to enter the United States, and that possession of the visa does not entitle you to enter the United States if, upon your arrival, you are found to be inadmissible under U.S. immigration laws. You certified that you understand that any willfully false or misleading statement or willful concealment of a material fact made by you within the application may subject you to permanent exclusion from the United States and, if you are admitted to the United States, may subject you to criminal prosecution and/or deportation.

The information that you have provided in your application and other information submitted with your application may be accessible to other government agencies having statutory or other lawful authority to use such information, including for law enforcement and immigration law enforcement purposes. If fingerprints are collected as part of your application process, they may be used for the purpose of comparing them to other fingerprints in the FBI’s Next Generation Identification (NGI) fingerprint system or its successor systems (including civil, criminal, and latent fingerprint repositories). The photograph that you provide with your application may be used for employment verification or other U.S. law purposes.