Form DS-4085 Application for Additional Visa Pages or Miscellaneous Services

Form DS-4085 Instructions

The document requires an applicant to provide the following information

1. Detailed personal information. This section includes the filer's name as listed on passport, date of birth, place of birth, sex, social security number, mailing address, phone number, and email address.
2. Information about the applicant's current passport. An applicant must designate their current U.S. passport number and the date when it was issued.
3. Permanent address. If an applicant's residence is different from their mailing address, or if an applicant listed their PO Box under their mailing address, they must fill in this section.
4. Emergency contact. Individuals must provide an emergency contact - a person not traveling with them who can be contacted in case of an emergency.
5. Occupation. If the filer is 16 years old or older, they must provide information about their occupation, employment, or school.
6. Additional contact phone number. It can be a home, work, cell, or any other phone number.
7. Travel plans. The filer must enter the date of departure, the return date, and the countries that they plan to visit.

The application is accompanied by an instruction sheet, which is supposed to be detached from the form and kept in the filer's records.