HHY-2017-Online Nonimmigrant Visa Application (DS-160).note¶
Source:
/Volumes/X9 Pro/ObsNotes/YoudaoYunNotes/HHY-2017-Online Nonimmigrant Visa Application (DS-160).note.pdfConverted: 2025-12-10 12:17:10
2018 DS160 Application ID for HHY: AA00875UU0, AA0089BGKA, AA008AEPME
HHY 11/12/2017 Application ID#: AA007EQBYG
Consular Electronic Application Center - Print Applic….pdf 302.15KB
Confirmation Number:
Personal, Address, Phone, and Passport/Travel Document Information
Name Provided: HUANG, HAIYUAN
Full Name in Native Language: 黄海渊
Other Names Used: NO
Telecode Name Used: YES
Telecode Name 7806, 3189 3220
Sex: MALE
Marital Status: MARRIED
Date of Birth: 02 SEPTEMBER 1974
Place of Birth: ZHANGZHOU, FUJIAN,
CHINA
Country/Region of Origin (Nationality): CHINA
Do you hold or have you held any nationality other than
the one indicated above on nationality? NO
Are you a permanent resident of a country/region other
than your country/region of origin (nationality) above? YES
Other Permanent Resident Country/Region (1): CANADA
National Identification Number: 120104197409026813
U.S. Social Security Number: 858983669
U.S. Taxpayer ID Number: DOES NOT APPLY
Home Address: 2863 WATERFRONT DRIVE
City: MONUMENT
State/Province: COLORADO
Postal Zone/ZIP Code: 80132
Country/Region: UNITED STATES OF
AMERICA
Same Mailing Address? YES
Primary Phone Number: 0017192082858
Secondary Phone Number: 0017195518117
Work Phone Number: 0017195314215
Email Address: hhy@agilent.com
Passport/Travel Document Type: REGULAR
Passport/Travel Document Number: E29737781
Passport Book Number: DOES NOT APPLY
Country/Authority that Issued Passport/Travel Document:CHINA
City Where Issued: BEIJING
Country/Region Where Issued: CHINA
Issuance Date: 16 SEPTEMBER 2014
Expiration Date: 15 SEPTEMBER 2024
Have you ever lost a passport or had one stolen?NO
Travel Information
The List of Purposes of Trip to the U.S.
Purpose of Trip to the U.S. (1): INTRACOMPANY
TRANSFEREE (L)
Specify: INTRACOMPANY
TRANSFEREE (L1)
Application Receipt/Petition Number: WAC1504850610
Have you made specific travel plans? NO
Intended Date of Arrival: 20 JANUARY 2018
Intended Length of Stay in U.S.: 3 YEAR(S)
Address where you will stay in the U.S.: 2863 WATERFRONT DRIVE
Person/Entity Paying for Your Trip: U.S. PETITIONER
Are there other persons traveling with you? YES
Are you traveling as part of a group or organization?NO
Persons Traveling with You:
Name (1): LIN, JINGHUAN
Relationship to You: SPOUSE
Have you ever been in the U.S.? YES
Date Arrived (1): 13 DECEMBER 2015
Length of Stay: 4 WEEK(S)
Date Arrived (2): 29 FEBRUARY 2016
Length of Stay: 12 MONTH(S)
Date Arrived (3): 08 MARCH 2017
Length of Stay: 4 MONTH(S)
Date Arrived (4): 04 JULY 2017
Length of Stay: 2 MONTH(S)
Date Arrived (5): 13 SEPTEMBER 2017
Length of Stay: 4 MONTH(S)
Do you or did you hold a U.S. Driver's License? YES
Driver's License Number (1): 07-170-0343
State of Driver's License: COLORADO
Have you ever been issued a U.S. Visa? YES
Date Last Visa was Issued: 13 JANUARY 2016
Visa Number: K2259595
Are you applying for the same type of visa? YES
Are you applying in the same country where the visa
above is issued and is this country your principal country
of residence?
YES
Have you been ten-printed? YES
Has your U.S. Visa ever been lost or stolen? NO
Has your U.S. Visa ever been cancelled or revoked? NO
Have you ever been refused a U.S. Visa, or been refused
admission to the United States, or withdrawn your
application for admission at the port of entry?
NO
Has anyone ever filed an immigrant petition on your
behalf with the United States Citizenship and
Immigration Services?
YES
Explain:
ON AUGUST 8TH, 2016,
FRAGOMEN LEGAL HAS
FILED AN I-140
IMMIGRANT PETITION ON
MY BEHALF. I-140 RECEIPT
: LIN1690907169. IT IS¶
STILL PENDING.
U.S. Contact Information
Contact Person Name in the U.S.: RACINE, JIM
Organization Name in the U.S.: AGILENT TECHNOLOGIES
INC
Relationship to You: U.S. PETITIONER
Family Information
Father's Surnames: HUANG
Father's Given Names: FEICHANG
Father's Date of Birth: DO NOT KNOW
Is your father in the U.S.? NO
Mother's Surnames: LIN
Mother's Given Names: XIULIAN
Mother's Date of Birth: DO NOT KNOW
Is your mother in the U.S.? NO
Do you have any immediate relatives, not including
parents in the U.S.? YES
Relative Name (1): HUANG, ZIYUN
Relationship to you: CHILD
Status: NONIMMIGRANT
Spouse's Full Name: LIN, JINGHUAN
Spouse's Date of Birth: 15 SEPTEMBER 1973
Spouse's Country/Region of Origin (Nationality): CHINA
Spouse's City of Birth: JILIN
Spouse's Country/Region of Birth: CHINA
Spouse’s Address: SAME AS HOME ADDRESS
Work/Education/Training Information
Primary Occupation: COMPUTER SCIENCE
Present Employer or School Name: AGILENT TECHNOLOGIES
CO LTD
Address: 1902 GARDEN OF THE
GODS
City: COLORADO SPRINGS
State/Province: COLORADO
Postal Zone/Zip Code: 80907
Country/Region: UNITED STATES OF
AMERICA
Work Phone Number: 7195314215
Monthly Salary in Local Currency (if employed): 9400
Briefly Describe your Duties:
MANAGE THE DESIGN AND
IMPLEMENTATION OF
BUSINESS-CRITICAL IT
INFRASTRUCTURE. ENGAGE
CUSTOMERS TO DEFINE
AND DOCUMENT BUSINESS
REQUIREMENTS, PROVIDE
CONSULTATION AND
COORDINATE THE
SOLUTION &
ARCHITECTURE DESIGN,
AND MANAGE THE
DEPLOYMENT AND
REGULAR REVIEWS
THROUGH 3RD PARTY
VENDORS.
Were you previously employed? NO
Have you attended any educational institutions at a
secondary level or above? YES
Name of Institution (1): TSINGHUA UNISVERSITY
Address of Institution: TSINGHUA UNISVERSITY
HAIDIAN DISTRICT
City: BEIJING
State/Province: DOES NOT APPLY
Postal Zone/ZIP Code: 100084
Country/Region: CHINA
Course of Study: BUSINESS
ADMINISTRATION
Date of Attendance From: 01 SEPTEMBER 1999
Date of Attendance To: 30 MAY 2001
Name of Institution (2): NANKAI UNIVERSITY
Address of Institution: NO 94 WEI JIN LU
City: TIANJIN
State/Province: DOES NOT APPLY
Postal Zone/ZIP Code: 300071
Country/Region: CHINA
Course of Study: INFORMATION SYSTEM
Date of Attendance From: 01 SEPTEMBER 1991
Date of Attendance To: 30 JUNE 1995
Do you
belong to a
clan or tribe?
NO
Provide a
List of
Languages
You Speak:
Language
Name (1): CHINESE
Language
Name (2): ENGLISH
Have you
traveled to
any
countries/re
gions within
the last five
years?
YES
Provide a
List of
Countries/Re
gions Visited
Country/Regi
on (1): GERMANY
Country/Regi
on (2): CANADA
Country/Regi
on (3): SWITZERLAN
D
Country/Regi
on (4): KENYA
Country/Regi
on (5): HONG KONG
Country/Regi
on (6):
UNITED
STATES OF
AMERICA
Have you
belonged to,
contributed
to, or
worked for
any
professional,
social, or
charitable
organization
?
NO
Do you have
any
specialized
skills or
training,
such as
firearms,
explosives,
nuclear,
biological, or
chemical
experience?
NO
Have you
ever served
in the
military?
NO
Have you
ever served
in, been a
member of,
or been
involved with
a
paramilitary
unit,
vigilante
unit, rebel
group,
guerrilla
group, or
insurgent
organization
?
NO
Security and Background Information
Do you have a communicable disease of public health
significance? (Communicable diseases of public
significance include chancroid, gonorrhea, granuloma
inguinale, infectious leprosy, lymphogranuloma
venereum, infectious stage syphilis, active tuberculosis,
and others diseases as determined by the Department of
Health and Human Services.)
NO
Do you have a mental or physical disorder that poses or
is likely to pose a threat to the safety or welfare of
yourself or others?
NO
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, amnesty, or
other similar action?
NO
Have you ever violated, or engaged in a conspiracy to
violate, any law relating to controlled substances? NO
Are you coming to the United States to engage in
prostitution or unlawful commercialized vice or have you
been engaged in prostitution or procuring prostitutes
within the past 10 years?
NO
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 outside
the United States?
NO
Are you the spouse, son, or daughter of an individual
who has committed or conspired to commit a human
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?
NO
Have you knowingly aided, abetted, assisted or colluded
with an individual who has committed or conspired to
commit a severe human trafficking offense in the United
States or outside the United States?
NO
Do you seek to engage in espionage, sabotage, export
control violations, or any other illegal activity while in the
United States?
NO
Do you seek to engage in terrorist activities while in the
United States or have you ever engaged in terrorist
activities?
NO
Have you ever or do you intend to provide financial
assistance or other support to terrorists or terrorist
organizations?
NO
Are you a member or representative of a terrorist
organization? NO
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
killings, or other acts of violence?
NO
Have you ever engaged in the recruitment or the use of
the child soldiers? NO
Have you, while serving as a government official, been
responsible for or directly carried out, at any time,
particularly severe violations of religious freedom?
NO
Have you ever been directly involved in the
establishment or enforcement of the population controls
forcing a woman to undergo an abortion against her free
choice or a man or a woman to undergo sterilization
against his or her free will?
NO
Have you ever been directly involved in the coercive
transplantation of human organs or bodily tissue? NO
Have you ever been the subject of a removal or
deportation hearing? NO
Have you ever sought to obtain or assist others to obtain
a visa, entry into the United States, or any other United
States immigration benefit by fraud or willful
misrepresentation or other unlawful means?
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 or
otherwise violated the terms of a U.S. visa?
NO
Have you ever withheld custody of a U.S. citizen child
outside the United States from a person granted legal
custody by a U.S. court?
NO
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
Are you a former exchange visitor (J) who has not yet
fulfilled the two-year foreign residence requirement? NO
Have you attended a public elementary school on student
(F) status or a public secondary school after November
30, 1996 without reimbursing the school?
NO
Temporary Work Visa Information
Application Receipt/Petition Number: WAC1504850610
Name of Person/Company who Filed Petition: AGILENT TECHNOLOGIES
INC
Where Do You Intend to Work?
Name of Employer: AGILENT TECHNOLOGIES
INC
Street Address: 1902 GARDEN OF THE
GODS RD
COLORADO SPRINGS,
COLORADO 80907
Phone Number: 7195314568
Monthly Income (in USD): $9,400
Location Information
Location where you will be submitting your application
Current Location: BEIJING, CHINA
Preparer of Application
Did anyone assist you in filling out this application?NO