6/20/23, 6:07 PM Non-Immigrant Visa - Review Personal, Address, Phone, and Passport Information
Online Nonimmigrant Visa Application (DS-160) Application ID AA00C15JA3
Personal, Address, Phone, and Passport Information
Note: You have completed data entry for your NIV application. Before submitting the application, please review your entries below. To
navigate to the next section to be reviewed, click the ‘Next’ button on the bottom of the page. If an entry is incorrect, click on the links on
the right side of the page, which will direct you to the page where you entered the data. Once you have reviewed all sections, you will be
directed to the Sign and Submit page to complete the application process.
Photo Provided: Upload New Photo
DO NOT BRING THIS TO YOUR INTERVIEW
Edit Personal Information
Name Provided: SANDUKHADZE, RUSLANI
Full Name in Native Alphabet: სანდუხაძე რუსლანი
Other Names Used: NO
Telecode Name Used: NO
Sex: MALE
Marital Status: MARRIED
Date of Birth: 14 OCTOBER 1972
Country/Region of Birth: UKRAINE, UKRAINE
Country/Region of Origin (Nationality): GEORGIA
Do you hold or have you held any nationality other than the one NO
indicated above on nationality?
Are you a permanent resident of a country/region other than your NO
country/region of origin (nationality) above?
National Identification Number: 60002012850
U.S. Social Security Number: DOES NOT APPLY
U.S. Taxpayer ID Number: DOES NOT APPLY
Edit Address and Phone Information
Home Address: 10 BAGRATIONI STR
City: KUTAISI
State/Province: DOES NOT APPLY
Postal Zone/ZIP Code: 4600
Country/Region: GEORGIA
Same Mailing Address? YES
Primary Phone Number: +995577345501
Secondary Phone Number: DOES NOT APPLY
Work Phone Number: DOES NOT APPLY
DO NOT BRING THIS TO YOUR INTERVIEW
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6/20/23, 6:07 PM Non-Immigrant Visa - Review Personal, Address, Phone, and Passport Information
DO NOT BRING THIS TO YOUR INTERVIEW
Have you used additional phone numbers in the last five years? NO
Have you used additional email addresses in the last five years? YES
Do you have a social media presence?
Social Media Provider/Platform (1): FACEBOOK
Social Media Identifier: HTTPS://WWW.FACEBOOK.COM/RUSLAN.SANDUKHADZE
Social Media Provider/Platform (2): INSTAGRAM
Social Media Identifier: HTTPS://WWW.INSTAGRAM.COM/RUSLANSANDUKHADZE/
Social Media Provider/Platform (3): LINKEDIN
Social Media Identifier: HTTPS://WWW.LINKEDIN.COM/IN/RUSLAN-SANDUKHADZE-
49B
Social Media Provider/Platform (4): TWITTER
Social Media Identifier: HTTPS://TWITTER.COM/RSANDUKHADZE
Social Media Provider/Platform (5): YOUTUBE
Social Media Identifier: HTTPS://WWW.YOUTUBE.COM/@RUSLANSANDUKHADZE3937
Have you used additional social media platforms in the last five years? YES
Social Media Provider/Platform (1): OK.RU
Social Media Identifier: HTTPS://OK.RU/RUSLAN.SANDUKHADZE
Edit Passport/Travel Document Information
Passport/Travel Document Type: REGULAR
Passport/Travel Document Number: 17AA36411
Passport Book Number: DOES NOT APPLY
Country/Authority that Issued Passport/Travel Document: GEORGIA
City where issued: TBILISI
Country/Region where issued: GEORGIA
Issuance Date: 17 JANUARY 2018
Expiration Date: 17 JANUARY 2028
Have you ever lost a passport or had one stolen? NO
DO NOT BRING THIS TO YOUR INTERVIEW
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