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NOTIFICATION OF APPOINTMENT AND CAREER CONSULAR OFFICER OF

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(c) MIDDLE(b) GIVEN (First)(a) SURNAME (Last)
CONTACT NAME AND TELEPHONE NO.
10. LAST ARRIVAL IN U.S.A. (mm-dd-yyyy)
2. TYPE OF OFFICER
DIPLOMATIC CONSULAR
EMBASSY
OTHER
INTERNATIONAL MONETARY FUND
3. FULL NAME
(d) PREFIX OR RANK (e) SUFFIX (f) MAIDEN (g) OTHER
MALE FEMALE
Is the correct sequence for printing name a, b, c, e?
YES NO.
If No, give correct sequence:
ABBREVIATED
NAME:
Please indicate how name should appear on documents (identification cards, etc.) Surname first.
4. CURRENT CITIZENSHIP
6. CITIZENSHIP AT BIRTH 7. PLACE OF BIRTH (City, Country)
8. TYPE OF PASSPORT
DIPLOMATIC OFFICIAL REGULAR OTHER
9. TYPE OF VISA
A1 A2 OTHER
G1 G2 G3 G4
(Specify type)
ATTACH COPIES OF ENTRY/DEPARTURE FORM I-94, AND TITLE AND VISA PAGES FROM PASSPORT. STAPLE TO FORM.
DATE:
5. DATE OF BIRTH (mm-dd-yyyy)
PORT OF ENTRY MANNER OF ENTRY
11. RESIDENCE ADDRESS
TEMPORARY PERMANENT
NUMBER STREET (AVE., BLVD, PLACE, ETC.) APT.
CITY STATE ZIP
TELEPHONE
12. EMPLOYING OFFICE
NUMBER STREET (AVE., BLVD, PLACE, ETC.) SUITE
CITY STATE ZIP
TELEPHONE
NAME OF OFFICE
13. DUTY OFFICE (If different from employing office)
NUMBER STREET (AVE., BLVD, PLACE, ETC.) SUITE
CITY STATE
ZIP
TELEPHONE
NAME OF OFFICE
EXT. EXT.
15. DATE OF ENTRY ON DUTY (mm-dd-yyyy)14. JOB TITLE
Head of post?
YES NO
16. EXPECTED DATE OF DEPARTURE (mm-yyyy)
18. WILL OFFICER SERVE IN ANOTHER OFFICIAL CAPACITY?
YES NO If YES, give position and duty office:
19. ARE ANY IMMEDIATE FAMILY MEMBERS EMPLOYED BY A
FOREIGN GOVERNMENT IN THE UNITED STATES?
If YES, give names and duty office:
EACH PERSON MUST SUBMIT A SEPARATE NOTIFICATION OF
APPOINTMENT.
U.S. Department of State
NOTIFICATION OF APPOINTMENT
OF FOREIGN DIPLOMATIC OFFICER
AND CAREER CONSULAR OFFICER
1. FROM (Name of Embassy/Mission)
TO: Secretary of State, Attention - Office of Protocol
WORLD BANK
MISSION TO INTERNATIONAL ORGANIZATION
OMB APPROVAL NO. 1405-0062
EXPIRATION DATE: 06-30-2006
ESTIMATED BURDEN: 25 MINUTES *
17. NAME, TITLE AND PID (IF AVAILABLE) OF PREDECESSOR AND
DATE (mm-yyyy) OF TERMINATION
FOR OFFICIAL USE ONLY
P R
A T
PID Recognition Date (mm-dd-yyyy)
DS-2003
06-2003
(Formerly DSP-110)
Page 1 of 4
YES NO
20. ALL PREVIOUS ASSIGNMENTS WITHIN THE UNITED STATES (If not listed in item 21 below, including study and training)
(List To/From (mm-yyyy))
21. ALL ASSIGNMENTS/POSITIONS/ACADEMIC STUDIES/OTHER ACTIVITIES WITHIN PAST FIVE YEARS (Dates, nature of activity, and location -
beginning with most recent) (List To/From (mm-yyyy))
22. FAMILY MEMBERS Residing in household in the United States (Use DS-2007 continuation sheet if necessary; Staple to this form)
(a) SURNAME (Last) (b) GIVEN (First) (c) (Middle)
(d) PREFIX (e) SUFFIX (f) MAIDEN (g) OTHER
MALE FEMALE
23. PLEASE INDICATE IF REQUESTING IDENTIFICATION CARDS FOR DEPENDENT:
YES NO.
Attach envelope with 4 recent
photographs of principal, 5 for
Ambassador
Intentional provision of false information on this form violates United States law (Title 18 U.S. Code, Section 1001)
and will be considered a violation of the international legal obligation of foreign missions and their personnel to respect
the laws of the receiving state (Vienna Convention on Diplomatic Relations, 1961, Article 41; Vienna Convention on
Consular Relations, 1963, Article 55).
ANY CHANGES IN THIS INFORMATION MUST BE REPORTED
IMMEDIATELY TO THE OFFICE OF PROTOCOL (USE FORM DS-2006,
NOTIFICATION OF CHANGE)
SIGNATURE OF APPLICANT DATE (mm-dd-yyyy)
TYPED NAME & SIGNATURE OF CHIEF OF MISSION
OR AUTHORIZED DEPUTY
DATE (mm-dd-yyyy)
(Embassy Seal)
PRIVACY ACTS and PAPERWORK REDUCTION ACT STATEMENTS
(h) RELATIONSHIP
Is the correct sequence for printing name a, b, c, e?
YES
NO.
If No, give correct sequence:
ABBREVIATED
NAME:
Please indicate how name should appear on documents (identification cards, etc.) Last name first.
2" x 2"
Color
Attach 3 photographs for
spouses of diplomats, 4 for
spouse of Ambassador
Attach 2 photographs for each
dependent eligible for an
identification card.
Print name and mission on
back of each photo
The Privacy Act of 1974, as amended, 5 U.S.C. 552a, contains provisions regarding the maintenance, collection, use, and dissemination of
information about United States citizens and aliens lawfully admitted for permanent residence in the United States. The following information is
provided in accordance with subsection (e)(3) of the Privacy Act.
AUTHORITIES:
Vienna Convention on Diplomatic Relations of 1961; Vienna Convention on Consular Relations of 1963; Diplomatic Relations Act (22 U.S.C.
254a-e); International Organizations Immunities Act (22 U.S.C. 288e(a)).
PURPOSE: The principal purpose for the collection of this information is to implement various provisions of the above-cited authorities which are predicated upon
acceptance by the U.S. Department of State.
ROUTINE USES: The principal users of this information are offices within the U.S. Department of State, including but not limited to, the Office of Protocol, the
Office of Foreign Missions, and the Office of Visa Services. In response to inquiries from law enforcement agencies, the Office of Protocol may confirm status as
recognized by the U.S. Department of State. Information may also be provided to other government agencies having statutory or other lawful authority to maintain
such information. Certain information specifically related to the operation and activities of the Executive Council on Foreign Diplomacy or The Hospitality and
Information Service (THIS) may be provided to those organizations. Names of the members of the diplomatic staff, office addresses, titles, and names of spouses are
published quarterly in the Diplomatic List, U.S. Department of State Publication 10424. Names of Consular Officers, titles, and office addresses are published
semiannually in Foreign Consular Offices in the United States, U.S. Department of State Publication 10277.
Submission of these forms is mandatory. Failure to provide any of the requested information may prevent acceptance and the extension of benefits to
principals or family members as provided in the above-cited authorities.
DS-2003
*Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time required for searching existing data
sources, gathering the necessary data, providing the information required, and reviewing the final collection. In accordance with 5 CFR 1320.5(b), persons are not
required to respond to the collection of this information unless this form displays a currently valid OMB control number. Send comments on the accuracy of this
estimate of the burden and recommendations for reducing it to: U.S. Department of State (A/RPS/DIR) Washington, DC 20520.
Page 2 of 4
CITIZENSHIPPLACE OF BIRTH (City, Country)DATE OF BIRTH (mm/dd/yyyy) VISA STATUS (Attach copies)
Clear
This form is to be completed for all diplomatic and career consular officers of all foreign missions. All questions should be answered
completely and accurately. If a question does not apply, please type N/A.
Any changes in the information provided on this form should be reported to the Office of Protocol as soon as possible using the
Notification of Change, Form DS-2006.
NOTE: It is important that all information provided to the Office of Protocol and the Office of Foreign Missions be consistent.
Discrepancies, such as in the spelling of the name, the residence address, date of birth, etc., may delay processing applications for
identification cards, tax exemption cards, drivers licenses, and automobile registrations.
The instructions below are numbered to correspond to the numbered items on the form. PLEASE TYPE ALL ANSWERS.
INSTRUCTIONS FOR COMPLETING FORM DS-2003,
NOTIFICATION OF APPOINTMENT OF FOREIGN DIPLOMATIC
OR CONSULAR OFFICER
Please Read All Instructions Before Completing This Form.
9 Enter "X" in box idicating type of United States visa held in
passport. Make a photocopy of the front (and back if annotated) of the
Entry/Departure Form I-94, and the title and visa pages (showing name
and date of birth) from the officer's passport and staple them to the back
of the form. NOTE: If a Machine Readable Visa (MRV) has been
issued, it is not necessary to submit title pages from the passport. (An
MRV contains the visa holder's photo.)
12 Enter the name, address, and telephone number of foreign embassy,
mission or post where the officer will be assigned.
15 Enter the date (mm-dd-yyyy) officer assumed present official duties
in the United States.
2 Enter an "X" in the box to indicate if the officer is a
DIPLOMATIC or CONSULAR officer. Enter and "X" to
indicate the type of office or mission to which the officer is
assigned.
1 Enter the name of the Embassy or Mission submitting
the form. Give telephone number of office which can be
contacted for further information, if necessary.
4 Enter present nationality.
6 Enter nationality at birth, even if the same as No. 4.
8 Enter "X" in box indicating type of passport.
13 Enter the name, address, and telephone number of the actual office
or annex where the officer will be working, if different from No. 12.
NOTE: All addresses must be street addresses, including
type, e.g. Street, Ave., Blvd., etc., not post office box
numbers, and must include ZIP codes and telephone area
codes.
14 Enter title of position, e.g. Minister (Political), Attache
(Agriculture), Third Secretary (Commercial), Consul General, etc. Enter
"X" in box if officer is the head of a post or mission.
16 Enter the date (mm-yyyy), (approximate) that officer will terminate
duties in the United States.
17 Enter name, title and Personal Identification Number (PID), if
available, of the person the officer is replacing. Enter date (mm-yyyy),
of termination of predecessor. If new position, so state.
5 Enter officer's date of birth (mm-dd-yyyy).
7 Enter officer's place of birth - city and country or state.
NOTE: Names on identification cards will be printed:
last, first, middle, in the order of a, b, c, e, on No. 3 of the
form. If this is not the correct sequence for the officer's
name, indicate correct sequence in the spave provided.
(Example: f, b, g, e). Due to space limitations it may not be
possible to include all names on identification cards. In the
block spaces after "Abbreviated Name" type the officer's
name as it should appear on identifiction card, using no
more than 34 spaces, and allowing spaces for commas and
periods.
NOTE: The abbreviated name, if used, will appear in all
publications and documents issued by the U.S. Department
of State.
3 Enter the officer's full name in the order specified: (a)
surname or family name; (b) first name or given name; (c)
middle name; (d) prefix such as Mr., Mrs., Ms., or Miss,
military rank, or title; (e) suffix, such as Jr. or Sr.; (f) maiden
name, and (g) any other name used. Type "X" to indicate if
male or female.
10 Enter date (mm-dd-yyyy), of arrival in the United States, port of
entry, and manner, e.g., plane, car, etc.
11 Enter residence address (not duty address unless actually living and
working at the same location), in the United States where officer
currently resides. If temporary (hotel, etc.), use Form DS-2006 to notify
the Office of Protocol when officer moves to a permanent address.
Page 3 of 4
DS-2003
and attach photocopies of front (and back if annotated) of Form
I-94 and the title and visa pages from each dependent's passport.
NOTE: If a Machine Readable Visa (MRV) has been issued, it is
not necessary to submit title pages from the passport. (An MRV
contains the visa holder's photo.)
ANY CHANGES IN THIS INFORMATION SHOULD BE REPORTED TO THE OFFICE OF
PROTOCOL USING NOTIFICATION OF CHANGE, FORM DS-2006
23 Enter "X" in appropriate boxes for an identification card.
Persons who should receive identification cards include: For
diplomats (a) principals. (b) spouses (except U.S. citizens), (c)
dependents (except U.S. citizens) who are unmarried children
between 16 and 21 years who reside with their parents or are
full-time students, or unmarried children under 23 years who
are full-time students (for students between 21 and 23 attach
family status justification form); for consular officers only the
consular officer, unless the sending state and the U.S. have a
bilateral agreement extending immunity to family members.
An envelope with four photographs (2" x 2") of the officer
(five for Ambassador) should be affixed to the form. NOTE:
Two additional color photographs of the spouse (three
photographs for spouses of diplomats, four for spouse of
Ambassador), and each dependent child over age 16 must be
included for those eligible for an identification card.
Photographs should have been taken within the past 12 months.
Print full name and foreign mission on the back of each photo.
The officer must sign and date (mm-dd-yyyy), the form. The
form must be signed and dated (mm-dd-yyyy), by the
designated approving embassy official, and the official embassy
seal must be affixed.
22 Enter names of all family memebers residing in the
household in the United States, following the same format as in
NO. 3 above. Use Form DS-2007 for additional names. Give
date of birth (mm-dd-yyyy), place of birth, (city country),
current citizenship, and relationship to principle employee.
Enter type of United States visa (A-1, B-2, etc.) currently held,
20 If not listed in item 21, enter dates (mm-yyyy), nature and
place (city and state) of all previous assignments (including
study and training) in the United States. List To/From
Month/Year (mm-yyyy).
19 If an immediate family member (spouse or dependent) is or
will be employed in the United States by a foreign government
or international organization, please identify and indicate
position or title, relationship and where the person is working.
The person must be notified separately to the Office of Protocol
using the appropriate form.
18 If officer will serve in any official capacity other than that
listed, such as a dual accreditation (e.g. diplomatic and consular
titles, diplomat at Embassy and O.A.S. or U.N.), enter position
title and mission. NOTE: Separate notification will be
required.
21 Enter the dates (mm-yyyy), nature of employment (job title
and employer), and place (city and country) of academic study
or other activities for previous 5 years, starting from the most
recent assignment prior to this one. List to/From--Month/Year
(mm-yyyy). (NOTE: For Nos, 20, 21, attach additional sheet,
if necessary.)
Submit forms (original and two copies) and attachments to
Office of Protocol
U.S. Department of State
Production Unit, State Annex 33
3507 International Place, NW
Washington, DC 20008-3034
Page 4 of 4
DS-2003
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Completed 29 June 2021

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