UNITED NATIONS

NATIONS UNIS

Application for G Visa

Make sure to carefully read the Guidelines before fillin out the for!" #ou can access these Guidelines by selectin the follo$in link% DS&'()* Guide"
+ID Nu!ber You will need your Personal Identification Number (PID) to complete the form. Your PID is assigned to you and your dependant family members by the U.S. Department of State when you are first registered as a new staff member consultant of the United Nations or other International !rgani"ation. You can obtain your and your family#s PIDs on i$See% by selecting& $ Topics (I$See% homepage' directly below the top banner) $ Tra,el (second last item on the fly$out menu) $ Visas (Na(igation bar on the ))S website) $ -.ind your +ID Nu!ber- (last item in the *$+ (isa table) !r by selecting this lin%& ,ind your PID number Should the PID loo%$up tool return an empty record' you may not ha(e been registered. Please send an e$mail including your full na!e' inde/ nu!ber and date of birth to one of the following contacts& UN Secretariat personnel& Info$)ra(el-un.org UNI./, personnel& delliott-unicef.org UNDP UN,P0 UN!PS personnel& ruth.esmilio-undp.org Di ital +assport +hoto You will ha(e to upload a digital passport si"e photo (colour) to complete the application. Please refer to the DS$12+3 *uide as well as to the Photo 4uality Standards *uide (http& tra(el.state.go( (isa guide guide56337.html) for more detailed information on the photo re8uirements. !ptions to obtain the photo include& 9a(e your digital passport photo ta%en at a local photo facility and ha(e it sa(ed on dis% Scan a normal printed 7#:7# passport photo to your computer (minimum resolution& 6;; dpi). Use a digital camera to produce your own photo according to the guidelines pro(ided abo(e. The photo !ust be sa,ed in "0+EG 1"0+G2 for!at and the file si3e !ay not e/ceed 'M4" T5E +5OTO MUST 4E 6ESS T5AN ( MONT5S O6D Application +acka e Your application pac%age for submission to the UN <isa !ffice through your /:ecuti(e !ffice must include the following Documents& 1. ,orm P).21 duly signed by your .ertifying !fficer 7. Staff members only& P).21 supplemental form in duplicate (do not print double sided) 6. )he .onfirmation page you print after completion of online form DS$12+3 (in duplicate) +. Your National Passport containing your current *$+ (isa and I$=+ card (see DS$12+3 *uide for additional details on Passport re8uirements) >. If you ha(e a new passport you must also submit your old passport containing your current *$+ (isa and I$=+ card

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UNITED NATIONS

NATIONS UNIS

2. ?hen applying for a dependent#s (isa renewal only' a copy of your own (alid *$+ (isa and I$=+ (front and bac%) @. If you were unable to successfully upload your photo to the application' one passport si"e (7#:7#) photograph that complies with the guidelines pro(ided in the Photo 4uality Standards *uide. Scroll down for form PT.61

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P).21 (;6$11)

UNITED NATIONS

NATIONS UNIS

Application for G&) Visa

(one form for each applicant) +rincipal Alien 1i"e" Staff Me!ber7 8ontractor7 etc"2
Aast Name

,irst and Biddle Names

UN Inde: No.

-
!fficial UN e$mail address (for notification purposes)

Signature Date (DD BB YYYY)

Applicant 1if different fro! abo,e2 Celationship to Staff Bember&

Aast Name

,irst and Biddle Names

UN Inde: No.

Signature Date (DD BB YYYY)

86I89 5E:E .O: T5E 6IN9 TO T5E DE+A:TMENT O. STATE ON6INE .O:M DS&'()*
To be co!pleted by 8ertifyin Officer I certify that the staff member
(Aast Name)

(,irst Name)

(Biddle Name)

has a contract agreement which e:pires on&

Date (DD BB YYYY)

/:ecuti(e 0dministrati(e !fficer (print Name) /:ecuti(e 0dministrati(e !fficer (signature)

Department !ffice Date (DD BB YYYY)

.or TTS use only

(Date recei(ed)

(Dy)

(Date processed)

(Dy)

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P).21 (;6$11)

UNITED NATIONS

NATIONS UNIS

Supple!entary Infor!ation !NAY )9/ PCIN.IP0A (S)0,, B/BD/C) BUS) SUDBI) )9IS SUPPA/B/N)0CY ,!CB Be sure to enter all information exactly as it appears in the National Passport Staff !e!ber 1G&) ,isa applicant2 Surname& ,irst and Biddle Names& Date of Dirth&
Day

0anuary
Bonth

Year

UN Inde: No.& PID No.& daytime phone& ()$$ $

e$mail address Barital Status& Spouse Surname& ,irst and Biddle Names& Date of Dirth& .ity of Dirth&
Day

8hoose one 0anuary

Bonth

Year

Nationality& .ountry of Dirth&

U"S" I!!i ration Status

(Should your spouse hold a visa status other than G !" please contact the #isa $ffice immediately.%

*$+ (isa holder

Permanent Cesident U.S. .iti"en

Does not reside in the US

!ther' please e:plain& Is your spouse a staff !e!ber;indi,idual contractor of the UN 8o!!on Syste!< No Yes' please specify& UN Inde: No.& 5o!e Address at Duty Station Street& Street 7 0pt. No& .ity& EIP code& State& UNDP UN!PS UN,P0 UNI./, PID No. (if %nown)& $ !ther' please e:plain&

Date 0pplicant Signature

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