Brazil (pt-br) 1Informações do Candidato2Local de Entrega3Local da Entrevista4Informações sobre taxas de visto5Análise6Pagamento Important Notice Important Information The information you enter for your appointment request must match the information on your DS-160. Please make sure the following details match your DS-160: First Name Last Name Passport Number Date of Birth Visa Class Nationality Country of Birth Upload Your DS-160 Confirmation Page*Accepted file types: pdf, Max. file size: 300 MB. Nome* Nome Sobrenome Pais / Autoridade que emitiu seu Passaporte*Por favor selecioneAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic Of TheCook IslandsCosta RicaCroatiaCubaCyprusCzech RepublicCôte D'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic OfIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic OfKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States OfMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalThe NetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian AuthorityPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts And NevisSaint LuciaSaint MartinSaint Pierre And MiquelonSaint Vincent And The GrenedinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard And Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsPaís de Nascimento*Por favor selecioneAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic Of TheCook IslandsCosta RicaCroatiaCubaCyprusCzech RepublicCôte D'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic OfIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic OfKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States OfMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalThe NetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian AuthorityPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts And NevisSaint LuciaSaint MartinSaint Pierre And MiquelonSaint Vincent And The GrenedinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard And Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsPaís de Residência Permanente*Por favor selecioneAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic Of TheCook IslandsCosta RicaCroatiaCubaCyprusCzech RepublicCôte D'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic OfIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic OfKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States OfMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalThe NetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian AuthorityPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts And NevisSaint LuciaSaint MartinSaint Pierre And MiquelonSaint Vincent And The GrenedinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard And Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsNúmero do passaporte*O número do passaporte que você inseriu no seu formulário DS-160.Classe do Visto*Please SelectB1 Business / Conference / Domestic EmployeeB1/B2 Business & Tourism (Temporary visitor)C1 TransitC1/D Crewmember in transitD1 CrewmemberE1 Treaty Trader / Child of an E1 / Spouse of an E1E2 Treaty Investor / Child of E2 / Spouse of an E2E3 Australian Spec. WorkerE3D Spouse or Child of an E3F1 StudentF2 Spouse or Child of an F1F3 Commuter StudentH1B Speciality OccupationH1B1 Chilean or Singaporean Spec. OccupationH1C Nurse in shortage areaH2A Agricultural WorkerH2B Nonagricultural WorkerH3 TraineeH4 Spouse / Child of H1BH4 Spouse / Child of H1B1H4 Spouse / Child of H1CH4 Spouse / Child of H2AH4 Spouse / Child of H2BH4 Spouse / Child of H3I Foreign Media Representative / Spouse or Child of an IJ1 Professional Exchange Visitor (e.g., physician, scholar)J1 Work Exchange Visitor (e.g., teacher, intern, summer work)J2 Spouse or Child of a J1 - Professional Exchange VisitorJ2 Spouse or Child of a J1 - Work Exchange VisitorL1 Intra-company TransfereeL2 Spouse or Child of an L1M1 StudentM2 Spouse or Child of an M1M3 Commuter StudentO1 Extraordinary AbilityO2 Alien Accompanying/AssistingO3 Spouse or Child of an O1 or O2P1 Internationally Recognized AlienP2 Artist/Entertainer Exchange ProgramP3 Artist / Entertainer in Cultural ProgramP4 Spouse or Child of a P1, P2, or P3Q1 Cultural Exhange VisitorR1 Religious WorkerR2 Spouse or Child of an R1T1 Victim of TraffickingT2 Spouse of a T1T3 Child of a T1T4 Parent of a T1T5/T6 Sibling of a T1 / Derivative Beneficiary of a T1TD Spouse or Child of a TNTN NAFTA ProfessionalU1 Victim of CrimeU2 Spouse of a U1U3 Child of a U1U4 Parent of a U1U5 Sibling of a U1Número DS-160*Insira o número do código de barras individual do DS-160 do solicitante. Está localizado no canto superior direito do seu DS-160 Página de confirmação e começa com AA-. por exemplo: AA007BRM26Número de petição*Geralmente começa com três letras EAC, WAC, LIN ou SRC, seguidas por 10 dígitos numéricos. Data de nascimento*DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Sexo* Masculino Feminino Telefone principal*e-mail* Endereço de e-mail Confirmar e-mail Cidade de residência*Estado de residência*(Other)ACALAMAPBACEDFESGOMAMGMSMTPAPBPEPIPRRJRNRORRRSSCSESPTOVocê teve um visto para entrar nos Estados Unidos emitido anteriormente?* Sim Não Nome do posto de emissão do visto*por favor selecioneBrasiliaPorto AlegreRecifeRio de JaneiroSao PauloIssuing Post Not ListedClasse de visto anterior*Please SelectB1 Business / Conference / Domestic EmployeeB1/B2 Business & Tourism (Temporary visitor)B2 Tourism / Medical TreatmentC1 TransitC1/D Crewmember in transitD1 CrewmemberE1 Treaty Trader / Child of an E1 / Spouse of an E1E2 Treaty Investor / Child of E2 / Spouse of an E2E3 Australian Spec. WorkerE3D Spouse or Child of an E3F1 StudentF2 Spouse or Child of an F1F3 Commuter StudentH1B Speciality OccupationH1B1 Chilean or Singaporean Spec. OccupationH1C Nurse in shortage areaH2A Agricultural WorkerH2B Nonagricultural WorkerH3 TraineeH4 Spouse / Child of H1BH4 Spouse / Child of H1B1H4 Spouse / Child of H1CH4 Spouse / Child of H2AH4 Spouse / Child of H2BH4 Spouse / Child of H3I Foreign Media Representative / Spouse or Child of an IJ1 Professional Exchange Visitor (e.g., physician, scholar)J1 Work Exchange Visitor (e.g., teacher, intern, summer work)J2 Spouse or Child of a J1 - Professional Exchange VisitorJ2 Spouse or Child of a J1 - Work Exchange VisitorL1 Intra-company TransfereeL2 Spouse or Child of an L1M1 StudentM2 Spouse or Child of an M1M3 Commuter StudentO1 Extraordinary AbilityO2 Alien Accompanying/AssistingO3 Spouse or Child of an O1 or O2P1 Internationally Recognized AlienP2 Artist/Entertainer Exchange ProgramP3 Artist / Entertainer in Cultural ProgramP4 Spouse or Child of a P1, P2, or P3Q1 Cultural Exhange VisitorR1 Religious WorkerR2 Spouse or Child of an R1T1 Victim of TraffickingT2 Spouse of a T1T3 Child of a T1T4 Parent of a T1T5/T6 Sibling of a T1 / Derivative Beneficiary of a T1TD Spouse or Child of a TNTN NAFTA ProfessionalU1 Victim of CrimeU2 Spouse of a U1U3 Child of a U1U4 Parent of a U1U5 Sibling of a U1Data de emissão do visto*DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Data de Vencimento do Visto*DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Você está viajando de outro país para solicitar um visto dos Estados Unidos no Brasil?* Sim Não Verifique todas as declarações que se aplicam* I am physically present in Brazil. My previous visa was issued when I was 18 years of age or older. I am applying for a B1 Domestic Employee visa. I am renewing a visitor visa that was issued with 10-year validity. My most recent visa application was refused. My previous visa was lost, stolen, or revoked. I answered “No” to all Medical, Criminal, Security, and Immigration Violation questions on the DS-160 form. I am applying for the same visa type as my previous visa. None of the above apply. O retorno de seus documentos para um local do Centro de Atendimento ao Candidato (ASC) é incluído como parte de sua taxa de visto. Por favor, selecione o local do ASC (Centro de Atendimento ao Candidato) onde você pegará seus documentos. Nota: Os candidatos são notificados por e-mail quando os documentos do visto estão prontos para serem retirados no Centro de Serviço do Candidato (ASC). Os candidatos precisarão agendar uma consulta no ASC para retirar seus documentos.Retirada de Documentos - Centro de Atendimento ao Solciitante de Visto (CASV) (sem taxa extra)*Please selectPorto Alegre Document Service Center (DSC) - Av. Assis Brasil, 1712, Porto Alegre, 91010001Sao Paulo ASC - Unidade Vila Mariana - Avenida Jose Maria Whitaker 370, Sao Paulo, 04057000Brasilia ASC - Aeroporto Internacional de Brasília, Brasília, 71608-900Rio de Janeiro ASC - Avenida Almirante Silvio de Noronha, Rio de Janeiro, 20021-010Recife Document Service Center (DSC) - Rua Alfândega, 35, Recife, 50030030Aos Cuidados de* Nome Sobrenome O nome inserido aqui deve coincidir com o nome na identificação (RG) que você ou a pessoa autorizada apresentará para receber a documentação. Caso você planeje realizar a coleta presencialmente, você deve incluir seu próprio nome nesse campo. Para menores com menos de 18 anos de idade, você deve inserir o nome do pai ou mãe autorizado a retirar esse documento. Data da entrevista Por favor, insira a data de entrevista desejada. Se essa data não estiver disponível, o primeiro dia de compromisso disponível será agendado. Por favor, note que compromissos anteriores podem estar disponíveis para emergências. Se a data que você recebe não se encaixa em seus planos de viagem, envie-nos um e-mail e solicitaremos um agendamento rápido para você.Selecione preferido Consulado dos EUA para sua entrevista de visto.*por favor selecioneBrasiliaRecifeRio De JaneiroSao PauloData da entrevista* DD slash MM slash YYYY Informações gerais sobre tarifas e serviços Somos uma agência privada de assistência para vistos dos EUA. Ao prosseguir, você autoriza nossa equipe a gerenciar todo o processo em seu nome, incluindo: Criação e/ou recuperação do seu perfil no sistema oficial da Embaixada dos EUA Pagamento da sua taxa de visto (MRV) Agendamento da sua entrevista consular Acompanhamento completo do seu caso Taxas MRV por categoria de visto A taxa MRV é a taxa oficial de solicitação de visto cobrada pelo governo dos EUA. O valor varia conforme a categoria: Categoria Exemplos Taxa MRV Não-petição B1/B2, F, J, M, C, D US$185 Baseado em petição H, L, O, P, Q, R US$205 Investidor/Tratado E US$315 Noivo(a) K US$265 Importante: a taxa MRV é não reembolsável, não transferível e válida por 365 dias. Taxa da agência Além da taxa MRV oficial do governo, cobramos uma taxa fixa de serviço de US$165 por candidato, não reembolsável. Criação/recuperação do seu perfil governamental Pagamento da taxa MRV em seu nome Agendamento da sua entrevista Processamento administrativo completo Incluído: UVA Visa Mock-Up Interview (Acesso Vitalício) Sessões ilimitadas de prática Todos os tipos de visto incluídos Feedback com inteligência artificial Gerador de carta convite com IA Guias passo a passo de agendamento Acesso via celular e desktop Atualizações vitalícias Política de pagamento e segurança Caso o titular do cartão tente alegar falsamente fraude e solicitar um estorno, isso poderá ser reportado às autoridades competentes e pode resultar no cancelamento do agendamento. Observação: verifique sua pasta de spam caso não receba nossos e-mails. Termos de serviço*Confirmo que as informações fornecidas neste formulário estão corretas e corretas, tanto quanto é do meu conhecimento. Li e concordei com a Isenção de Responsabilidade, os Termos e Condições e a Política Sem Reembolso e entendo que se trata de um processamento de terceiros. Se um titular do cartão tentar falsamente informar que uma transação foi fraudulenta e solicitar um estorno de uma taxa de inscrição, a Embaixada dos EUA será informada sobre o mesmo. Isso pode resultar no cancelamento de qualquer visto já agendado. Eu aceito os Termos de Serviço Por favor confirme uma classe de visto*B1 Business/ConferenceB1/B2 Business & TourismB2 Tourism/Medical TreatmentC1 TransitC1/D Crewmember in TransitD1 CrewmemberE1 Treaty TraderE2 Treaty InvestorE3 Australian Spec. WorkerE3D Spouse or Child of an F1F1 StudentF2 Spouse or child of an F1F3 commuter StudentH1B Speciality occupationH1B1 Chilean or Singaporean Spec. OccupationH1C Nurse in shortage areaH2A agricultural WorkerH3 TraineeH4 Spouse/Child of H1BH4 Spouse/Child of H1B1H4 Spouse/Child of H1CH4 Spouse/Child of H2AH4 Spouse/Child of H2BH4 Spouse/Child of H3I Foreign Media RepresentativeJ1 Exchange VisitorJ2 Spouse or Child of a J1L1 Intra-Company transfereeL2 Spouse Or Child of an L1M1 StudentM2 Spouse or Child of an M1M3 Commuter StudentO1 Extraordinary AbilityO2 Alien Accompanying/AssistingO3 Spouse or Child of an O1 or O2P1 Internationally recognized AlienP2 Artist/Entertainer Exchange ProgramP3 Artist/entertainer in Cultural ProgramP4 Spouse or Child of a P1, P2, or P3Q1 Cultural Exchange VisitorR1 Religious WorkerR2 Spouse/Child of an R1T1 Victim of traffickingT2 Spouse of a T1T3 Child of a T1T4 Parent of a T1T5 Sibling of a T1TD Spouse or Child of a TNTN NAFTA ProfessionalU1 Victim of CrimeU2 Spouse of a U1U3 Child of a U1U4 Parent of a U1U5 Sibling of a U1 Isso parece correto? {all_fields} Total $0.00 Assinatura eletrônica do candidato Nome Sobrenome Por favor digite o nome do candidatoBilling Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Expiration Date Security Code Cardholder Name Cardholder Phone Number*Phone number of the person paying for the appointment.Cardholder Email Address* Enter Email Confirm Email Email address of the person paying for the appointment.E-Signature of Cardholder* First Last Signature of the person paying for the appointment.Relationship with Applicant*Please SelectSelfFamily Member (Spouse/Partner/Parent/Sibling/Child/Other Relative)FriendCoworkerEmployerEmployeeBusiness PartnerClient/CustomerRelationship that you have with the visa applicant.Cardholder Signature*Signature of the person paying for the appointment.Consent and Authorization*I understand that by providing this authorization, I am consenting to UVA managing these processes on my behalf, and I confirm that I am fully responsible for any charges incurred as part of this service. I acknowledge that UVA is not affiliated with the United States government. I hereby authorize UVA to act on my behalf to make appointments and pay the non-refundable MRV fee for the purpose of this transaction. I certify under penalty of perjury under the laws of the United States of America that the foregoing is true and correct. I acknowledge and approve that entering my name in the signature field legally replace my physical signature. I Consent and Authorize this transaction.