Online Immigrant Visa and Alien Registration Application (DS-260)
Application - Sensitive But Unclassified(SBU)
Case Confirmation
Number: Number:
Personal, Address and Phone Information
Name Provided: SORIA MEZA , MARIA
Full Name in Native Language: DOES NOT APPLY/TECHNOLOGY NOT
AVAILABLE
Other Names Used: NO
Sex: FEMALE
Current Marital Status: MARRIED
Date of Birth: 10 OCTOBER 1966
City of Birth: COMAS
State/Province of Birth: LIMA
Country/Region of Birth: PERU
Country/Region of Origin (Nationality): PERU
Document Type: PASSPORT
Document ID: L46571474
Country/Authority that Issued Document: PERU
Issuance Date: 30 NOVEMBER 2023
Expiration Date: 30 NOVEMBER 2028
Do you hold or have you held any nationality other than the one you NO
have indicated above?
Present Address: AVENIDA 3 DE OCTUBRE 649
VILLA SR DE LOS MILAGROS
City: COMAS
State/Province: LIMA
Postal Zone/ZIP Code: DOES NOT APPLY
Country/Region: PERU
From Date: JUNE 2011
Have you lived anywhere other than this address since the age of YES
sixteen?
Previous Address (1): 10 N TEXAS AVENUE
City ATLANTIC CITY
State/Province: NEW JERSEY
Postal Zone/ZIP Code: 08401
Country/Region: UNITED STATES OF AMERICA
From: MAY 2005
To: JUNE 2011
Previous Address (2): AVENIDA 3 DE OCTUBRE 649
VILLA SR DE LOS MILAGROS
City COMAS
State/Province: LIMA
Postal Zone/ZIP Code: DOES NOT APPLY
Country/Region: PERU
From: JUNE 1998
To: MAY 2005
Previous Address (3): 334 MARSHALL AVENUE
City ENGLEWOOD
State/Province: NJ
Postal Zone/ZIP Code: 07631
Country/Region: UNITED STATES OF AMERICA
From: MAY 1995
To: JUNE 1998
Previous Address (4): JULIO C TELLO 666 KM 13
City COMAS
State/Province: LIMA
Postal Zone/ZIP Code: DOES NOT APPLY
Country/Region: PERU
From: OCTOBER 1966
To: MAY 1995
Primary Phone Number: 01151954293
Secondary Phone Number: DOES NOT APPLY
Work Phone Number: DOES NOT APPLY
Other Telephone Numbers Used: NO
Email Address: [Link]@[Link]
Other Email Addresses Used: NO
Social Media Provider/Platform: Facebook
Social Media User ID: MARIA ROCHA
Other Social Media Used: NO
Is your Mailing Address the same as your Present Address? NO
Mailing Address: 213 WEST 35TH STREET
SUITE 905
City: NEW YORK
State/Province: NEW YORK
Postal Zone/ZIP Code: 10001
Country/Region: UNITED STATES OF AMERICA
Permanent Address
Name of person currently living at address: JUSSARA ROCHA
U.S. Address: 21 BARTRAM AVENUE
ATLANTIC CITY, NEW JERSEY 08401
Phone Number: DOES NOT APPLY
Is this address where you want your Permanent Residence Card NO
(Green Card) mailed?
Please provide the address in the United States where you want your Permanent Residence Card (Green Card) mailed.
Contact Person: MONTEZA LAW FIRM PC
U.S. Address: 213 WEST 35TH STREET
SUITE 905
NEW YORK, NEW YORK 10001
Phone Number: DOES NOT APPLY
Family Information
Father's Surnames: SORIA CALDERON
Father's Given Names: ALEJANDRO
Date of Birth: DO NOT KNOW
City of Birth: COMAS
State/Province of Birth: LIMA
Country/Region of Birth: PERU
Is your father still living? NO
Year of death: 2005
Mother's Surnames at Birth: MEZA TORRES
Mother's Given Names: MARIA
Date of Birth: DO NOT KNOW
City of Birth: COMAS
State/Province of Birth: LIMA
Country/Region of Birth: PERU
Is your mother still living? YES
Spouse's Full Name: ROCHA, JORGE
Spouse's Date of Birth: 23 MARCH 1966
Spouse's City of Birth: COMAS
Spouse's State/Province of Birth: LIMA
Spouse's Country/Region of Birth: PERU
Spouse's Address: SAME AS INTENDED U.S. ADDRESS
Occupation: CULINARY/FOOD SERVICES
Date of Marriage: 06 JUNE 2006
Marriage City: ATLANTIC CITY
Marriage State/Province: NEW JERSEY
Marriage Country/Region: UNITED STATES OF AMERICA
Is your spouse immigrating to the [Link] you? NO
Is your spouse immigrating to the U.S. at a later date to join you? NO
Do you have any Previous Spouses? NO
Do you have any children? NO
Previous U.S. Travel Information
Have you ever been in the U.S.? YES
Were you issued an Alien Registration Number by the Department NO
of Homeland Security?
Provide information on your last five U.S. visits.
Date Arrived: (1) : 01 AUGUST 1995
Length of Stay: 30 MONTH(S)
Have you ever been issued a U.S. Visa? NO
Have you ever been refused a U.S. Visa, been refused admission to NO
the United States, or withdrawn your application for admission at the
port of entry?
Work/Education/Training Information
Primary Occupation: OTHER
Specify Other: BABBYSITTING
Present Employer or School Name: MYSEL FREELANCE
Address: AVENIDA 3 DE OCTUBRE 649
KILOMETERS 13
City: COMAS
State/Province: LIMA
Postal Zone/ZIP Code: DOES NOT APPLY
Country/Region: PERU
Do you have other occupations? NO
In which occupation do you intend to work in the U.S.? OTHER
Specify Other: BABYSITTING
Have you traveled to any countries/regions within the last five years? NO
Have you ever served in the military? NO
Petitioner Information
Petitioner is my: CHILD
Petitioner Name: ROCHA , JUSSARA
Petitioner Address: 214 FRANKLIN BLVD
City: PLEASANTVILLE
State/Province: NJ
Postal Zone/ZIP Code: 08232
Country/Region: UNITED STATES OF AMERICA
Telephone: (609)576-7071
Mobile/Cell Telephone: DOES NOT APPLY
Email Address: DOES NOT APPLY
Security and Background Information
Do you have a communicable disease of public health significance such as tuberculosis (TB)? NO
Do you have documentation to establish that you have received vaccinations in accordance with U.S. law? YES
Explain:
Do you have a mental or physical disorder that poses or is likely to pose a threat to the safety or welfare NO
of yourself or others?
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, NO
amnesty, or other similar action?
Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substances? NO
Are you the spouse, son, or daughter of an individual who has violated any controlled substance trafficking NO
law, and have knowingly benefited from the trafficking activities in the past five years?
Are you coming to the United States to engage in prostitution or unlawful commercialized vice or have you NO
been engaged in prostitution or procuring prostitutes within the past 10 years?
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 NO
outside the United States?
Have you ever knowingly aided, abetted, assisted, or colluded with an individual who has been identified NO
by the President of the United States as a person who plays a significant role in a severe form of
trafficking in persons?
Are you the spouse, son, or daughter of an individual who has committed or conspired to commit a human NO
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?
Do you seek to engage in espionage, sabotage, export control violations, or any other illegal activity while NO
in the United States?
Do you seek to engage in terrorist activities while in the United States or have you ever engaged in NO
terrorist activities?
Have you ever or do you intend to provide financial assistance or other support to terrorists or terrorist NO
organizations?
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 NO
providing financial assistance or other support to terrorists or terrorist organizations, in the last five years?
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 NO
killings, or other acts of violence?
Have you ever engaged in the recruitment of or the use of child soldiers? NO
Have you, while serving as a government official, been responsible for or directly carried out, at any time, NO
particularly severe violations of religious freedom?
Are you a member of or affiliated with the Communist or other totalitarian party? NO
Have you ever directly or indirectly assisted or supported any of the groups in Columbia known as the NO
Revolutionary Armed Forces of Columbia (FARC), National Liberation Army (ELN), or United Self-Defense
Forces of Columbia (AUC)?
Have you ever, through abuse of governmental or political position converted for personal gain, NO
confiscated or expropriated property in a foreign nation to which a United States national had claim of
ownership?
Are you the spouse, minor child, or agent of an individual who has through abuse of governmental or NO
political position converted for personal gain, confiscated or expropriated property in a foreign nation to
which a United States national had claim of ownership?
Have you ever been directly involved in the establishment or enforcement of population controls forcing a NO
woman to undergo an abortion against her free choice or a man or a woman to undergo sterilization
against his or her free choice?
Have you ever disclosed or trafficked in confidential U.S. business information obtained in connection with NO
U.S. participation in the Chemical Weapons Convention?
Are you the spouse, minor child, or agent of an individual who has disclosed or trafficked in confidential NO
U.S. business information obtained in connection with U.S. participation in the Chemical Weapons
Convention?
Have you ever sought to obtain or assist others to obtain a visa, entry into the United States, or any other NO
United States immigration benefit by fraud or willful misrepresentation or other unlawful means?
Have you ever been removed or deported from any country? NO
Have you ever been the subject of a removal or deportation hearing? 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 NO
or otherwise violated the terms of a U.S. visa?
Are you subject to a civil penalty under INA 274C? NO
Have you been ordered removed from the U.S. during the last five years? NO
Have you been ordered removed from the U.S. for a second time within the last 20 years? NO
Have you ever been unlawfully present and ordered removed from the U.S. during the last ten years? NO
Have you ever been convicted of an aggravated felony and been ordered removed from the U.S.? NO
Have you ever been unlawfully present in the U.S. for more than 180 days (but no more than one year) NO
and have voluntarily departed the U.S. within the last three years?
Have you ever been unlawfully present in the U.S. for more than one year or more than one year in the NO
aggregate at any time during the last 10 years?
Have you ever withheld custody of a U.S. citizen child outside the United States from a person granted NO
legal custody by a U.S. court?
Have you ever intentionally assisted another person in withholding custody of a U.S. citizen child outside NO
the United States from a person granted legal custody by a U.S. court?
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 or a public secondary school on student (F) status after NO
November 40, 1996 without reimbursing the school?
Do you seek to enter the United States for the purpose of performing skilled or unskilled labor but have NO
not yet been certified by the Secretary of Labor?
Are you a graduate of a foreign medical school seeking to perform medical services in the United States NO
but have not yet passed the National Board of Medical Examiners examination or its equivalent?
Are you a health care worker seeking to perform such work in the United States but have not yet received NO
certification from the Commission on Graduates of Foreign Nursing Schools or from an equivalent
approved independent credentialing organization?
Are you permanently ineligible for U.S. citizenship? NO
Have you ever departed the United States in order to evade military service during a time of war? NO
Are you coming to the U.S. to practice polygamy? NO
Are you a former exchange visitor (J) who has not yet fulfilled the two-year foreign residence NO
requirement?
Has the Secretary of Homeland Security of the United States ever determined that you knowingly made a NO
frivolous application for asylum?
Are you likely to become a public charge after you are admitted to the United States? NO
Social Security Number Information
Have you ever applied for a Social Security number? NO
Do you want the Social Security Administration to issue a Social YES
Security number and a card?
Do you authorize disclosure of information from this form to the YES
Department of Homeland Security, the Social Security Administration,
and such other U.S. Government agencies as may be required for the
purposes of assigning you a social security number (SSN) and issuing
you a Social Security card and do you authorize the Social Security
Administration to share your SSN with the Department of Homeland
Security?
Preparer of Application:
Did anyone assist you in filling out this application? NO
