MISPRINT ON THE VISA - REQUEST FOR CORRECTION - U.S. Embassy & Consulates in Japan

If you notice a misprint on your visa, please submit this form. We will determine the legitimacy of the correction request and provide you instructions by email on what to do next.

For Non-immigrant visas, corrections will only be available for unused visas within a year of their issuance. For immigrant visas, corrections will only be available for unused visas that are still valid.

This form is only used to inform us that your visa was not printed properly. This form cannot be used for general inquiries. For general inquiries, please use the Visa Information Service.

Electronic System for Travel Authorization (ESTA) is not a visa. Embassies cannot check the status of an ESTA application, provide details about ESTA denials, or resolve issues caused by an ESTA denial. For this information, please visit the U.S. Customs and Border Protection (CBP) website here. For ESTA corrections, please see Frequently Asked Questions here .

Full name (as in passport):

Date of birth:

Passport Number:

Gender:

Male

Female

Visa Type:

Annotation (if any):

At which office did you apply for your visa?

Telephone number:

E-mail address:(Required)

Travel date:(Required)

Explain your situation:

Privacy Act Statement

AUTHORITIES: The information on this form is requested pursuant to Title 8 of the United States Code (U.S.C.), including specifically 8 U.S.C. § 1104 (Powers and duties of Secretary of State) and §§ 1201-1202 (Issuance of visas; Application for Visas).

PURPOSE: We are requesting this information in order to review your visa case, to facilitate activities such as scheduling your appointment for a service, and conducting administrative processing for services including immigrant visa appointments, returning resident visas and boarding foils.

ROUTINE USE: This information may be disclosed to another domestic government agency, a private contractor, a foreign government agency, or to a private person or private employer in accordance with certain approved routine uses. These routine uses include, but are not limited to, law enforcement activities, employment verification, fraud prevention, border security, counterterrorism, litigation activities, and activities that meet the Secretary of State's responsibility to protect U.S. citizens and non-citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices Visa Records, STATE-39

DISCLOSURE: Providing this information is voluntary. Failure to provide all the information requested on this form may result in the individual and/or authorized representative’s inability to obtain relevant information regarding a consular service request.

Confidentiality Statement: INA Section 222(f) provides that visa issuance and refusal records shall be considered confidential and shall be used only for the formulation, amendment, administration, or enforcement of the immigration, nationality, and other laws of the United States. Certified copies of visa records may be made available to a court which certifies that the information contained in such records is needed in a case pending before the court.