Form Dhs 866 PDF Details

Form DHS 866 is a form used to apply for advance permission to enter the United States. Also known as a visa waiver application, this form is used by citizens of specific countries who are traveling to the US for temporary business or tourist purposes and do not have a valid visa. In order to complete the form, you will need to provide information about your trip, including your planned dates of travel and purpose of visit. You may also be asked to provide biographical information, such as your name, date of birth, and passport number. Completing this form accurately and submitting it well in advance of your trip will help ensure a smooth entry into the United States.

QuestionAnswer
Form NameForm Dhs 866
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdhs 866 michigan, Lansing, VII, discriminate

Form Preview Example

COMPLAINT UNDER AMERICANS WITH DISABILITIES ACT

(Title II) and Section 504

Michigan Department of Human Services

Instructions: Please fill out this form completely, in black ink or type. Sign and return to the address on page 2.

Complainant Name:

Address:

City

 

 

State

Zip Code

 

 

 

 

 

Telephone: Home:

(

)

 

 

Business:

(

)

 

 

 

 

 

 

Person Completing This Form:

 

(if other than the complainant)

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip Code

 

 

 

 

 

Telephone: Home:

(

)

 

 

Business:

(

)

 

 

 

 

 

 

 

County/Program that you believe has discriminated against you:

Name:

Address:

County:

City

State

Zip Code

Telephone Number:

()

When did the event occur? Date:

Describe the event providing the name(s) where possible for the individuals who were involved (use space on page

2 if necessary):

DHS-866 (Rev. 1-14) Previous edition obsolete. MS Word

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Has the complaint been filed with the Michigan Department of Civil Rights or the Federal Department of Justice or any other federal agency or court?

Yes

No

If yes give name of agency or court:

Contact Person:

Address:

City

State

Zip Code

Telephone Number:

()

Date Filed:

Do you intend to file with another agency or court?

Yes

No

Agency or Court:

Address:

City

State

Zip Code

Telephone Number:

()

Additional space for answers:

Signature:

Date

Return to:

Office of Human Resources

PO Box 30037

Lansing, MI 48909

Phone: (517) 335-3521

Fax: (517) 335-4673

Authority:

Sec.709(c), Title VII, Civil Rights Act of

Department of Human Services (DHS) will not discriminate against any individual or

group because of race, religion, age, national origin, color, height, weight, marital status,

 

1969, as amended.

 

sex, sexual orientation, gender identity or expression, political beliefs or disability. If you

Response: Voluntary

need help with reading, writing, hearing, etc., under the Americans with Disabilities Act,

 

 

Penalty:

None

you are invited to make your needs known to a DHS office in your area.

 

 

 

DHS-866 (Rev. 1-14) Previous edition obsolete. MS Word

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