Fillable NOTIFICATION OF APPOINTMENT OF HONORARY CONSULAR OFFICER Form DS-2005

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NOTIFICATION OF APPOINTMENT OF HONORARY CONSULAR OFFICER Form DS-2005

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The NOTIFICATION OF APPOINTMENT OF HONORARY CONSULAR OFFICER Form DS-2005 form is 4 pages long and contains:

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  • 24 check-boxes
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Country of origin: US
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The US Department of State (DOS) or the State Department, is the government official division that advises the President and performs international relations. Equivalent to the outside service of different nations, it was built up in 1789 as the country's first official department.

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INSTRUCTIONS FOR COMPLETING FORM DS-2005,
NOTIFICATION OF APPOINTMENT OF
HONORARY CONSULAR OFFICER
This form is to be completed for all honorary consular officers. 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 as soon as possible using the Notification of Change, Form
DS-2006.
The instructions below are numbered to correspond to the numbered items on the form. Please TYPE all answers.
Please read all instructions before completing this form.
2 Enter the honorary consular officer's full name in the order
specified: (a) surname (b) given name; (c) prefix such as Mr.,
Mrs., Ms., or Miss, or title; (d) suffix, such as Jr. or Sr.; and (e)
maiden name. Type "X" to indicate if male or female.
3 Enter present nationality.
4 Enter officer's date of birth (mm-dd-yyyy).
honorary consular officer.
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.
9
Enter date (mm-dd-yyyy) officer will assumed official duties in the
United States. NOTE: Honorary consuls may not be perform consular duties
until they have been recognized by the Department of State
10 Enter "X" in box indicating current residence Status of honorary
consul in the United States. (Only U.S. Citizens or permanent resident aliens
may serve as honorary consuls.)
11 Enter the date (mm-yyyy), (approximate) that officer will terminate
duties. (If unknown, so state)
12 Enter name, title and Personal Identification Number (PID), if available,
of the person the officer is replacing. If new position, so state.
13 Enter current occupation of honorary consular officer.
14 Enter "X" in box if officer has previously held any honorary consular
position with any foreign government. Indicate periods, title, country, and
location.
15 Enter the dates (mm-yyyy), nature of employment (job title and employer),
and place (city and state) of academic study or other activities for previous 10
years, starting from the most recent position. (Attach additional sheet, if
necessary. or curriculum vitae may be substituted).
1
Enter the name of the Embassy submitting
the form. Give telephone number and email address of office
which can be contacted for further information, if necessary.
Instruction page 1 of 2
DS-2005
05-2017
5 Enter nationality at birth, even if the same as No. 4.
6 Enter officer's place of birth - city and country or state.
7
Enter the name, address and telephone number of the
8
Enter complete home address, and telephone number of the honorary
consular officer. (If same as item 8, so state.) 2.
Submit all forms and attachments to
U.S. Department of State
3507 International Place, NW
Washington, DC 20008-3034
Requests to the Secretary must contain information concerning the
applicants status, and the nature the proposed employment in as much
detail as possible.
If the answer to any question is YES, please attach requested
documentation.
Color photograph (2" x 2") of the officer should be affixed to the form.
Photographs should have been taken within the past 12 months. Print full
name and foreign mission on the back of each photo.
The applicant for the position of honorary consular officer must sign and
date (mm-dd-yyyy) the form. The form must be signed and dated by the
designated approving embassy official, and the official embassy seal must
be affixed.
ANY CHANGES IN THE INFORMATION PROVIDED ON THIS FORM SHOULD BE REPORTED AS SOON AS POSSIBLE USING THE NOTIFICATION
OF CHANGE, FORM DS-2006.
19
The Emoluments Clause, Article I, Section 9, clause 8 of the
United States Constitution, provides: "...No person holding any Office
of Profit or Trust under them [the United States], shall, without the
consent of the Congress, accept of any present, Emolument, Office, or
Title, of any kind whatever from any King, Prince, or foreign State."
The U.S. Code of Federal Regulations, Volume 22, Chapter 1, Part 3a,
provides that Congress consents to the following persons accepting civil
employment from a foreign government, only if the Secretary of the
Department concerned and the Secretary of State have approved the
employment.
1) Retired members of the uniformed services.
2) Members of a reserve component of the armed forces.
3) Members of the Commissioned Reserve Corps of the Public
Health Service.
Thus, for example, a retired U.S. Army officer must obtain written approval
from the Secretary of the Army in order to take a position as an honorary
consular officer of a foreign state.
Instruction page 2 of 2
DS-2005
14. Will applicant be head of post?
U.S. Department of State
NOTIFICATION OF APPOINTMENT
OF HONORARY CONSULAR OFFICER
1. From (Name of Embassy/Mission)
TO: Secretary of State, Attention - Office of Foreign Missions
DS-2005
05-2017
2. Full Name
(a) Surname (Last) (b) Given Name
(d) Prefix
(e) Suffix
(f) Maiden
Male Female
3. Current Citizenship
5. Citizenship at Birth 6. Place of Birth (City, Country)
OMB APPROVAL NO. 1405-0105
EXPIRATION DATE: .05-31-2021
ESTIMATED BURDEN: 20 MINUTES*
4. Date of Birth (mm-dd-yyyy)
8.Residence Address (Do not use post office box)
Number Street (Ave., Blvd., Place, Etc.) APT.
City State ZIP
Telephone
7. Honorary Consulate Address (Do not use post office box)
Number Street (Ave., Blvd., Place, Etc.) Suite
City State ZIP
Telephone
Name of Office
16. Business Address (Do not use post office box)
Number Street (Ave., Blvd., Place, Etc.) Suite
City State ZIP
Telephone
Name of Office
Ext.
Ext.
9. Date of Entry on Duty (mm-dd-yyyy)
13. Current Occupation or Profession
11. Expected Date of Termination (mm-yyyy)
12. Name, Title and PID of Predecessor and Date (mm-dd-yyyy) of
Termination
15. Has applicant ever held a previous honorary consular position?
Yes No
(If "Yes", when, what title, what country, and where?)
Yes No
17. Attach curriculum vitae or list all assignments/positions/academic studies within past ten years.
FOR OFFICIAL USE ONLY
P R
A T
PID
Recognition Date (mm-dd-yyyy)
10. U.S. Residence Status
United States Citizen
Permanent Resident Alien A
Contact Name, Telephone Number, and Email Address
Page 1 of 2
(4) A retired member of the U.S. Department of State Foreign Service?
*Public reporting burden for this collection of information is estimated to average 20 minutes per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do not
have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this burden
estimate and/or recommendations for reducing it, please send them to: M/OFM, 3507 International Place NW, Washington, DC 20008.
Signature of Chief of Mission or Deputy
Signature of Applicant Date
(mm-dd-yyyy)
18. Conflict of Interest (To be answered by applicant)
Attach recent color
photograph
2" x 2"
Print name and mission on
back of each photo
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 Consular Relations, 1963, Article 55).
Any changes in the information provided on this form should be reported as
soon as possible using the Notification of Change, Form DS-2006.
(Embassy Seal)
DS-2005
Page 2 of 2
a. (1) Do you hold a position of profit or trust with the Federal Government?
YesNo
If answer is "Yes", identify the branch and position held.
(Attach description of duties performed.)
(2) Do you hold an office with a state, county, or municipal government in the United States?
YesNo
If "Yes", attach description of duties performed and include letter from the state, county, or municipality stating
that your position is not incompatible with the duties of a foreign consular officer, and that they have no objection
to your consular appointment.
b. Are you:
YesNo
If "Yes", state which:
(1) A retired member of the uniformed services of the United States (meaning the Armed Forces, the commissioned Regular and Reserve
corps of the Public Health Service, or the commissioned corps of the National Oceanic and Atmospheric Administration)?
YesNo
If "Yes", attach copy of letter of permission from the Secretary of the Department concerned.
YesNo
(3) A member of the Commissioned Reserve Corps of the United States Public Health Service?
(2) A member of a reserve component of the armed forces of the United States (meaning the Army, Navy, Air Force, Marine Corps, or
Coast Guard)?
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: The information is sought pursuant to Vienna Convention on Diplomatic Relations of 1961; Vienna Convention on Consular Relations of
1963; Diplomatic Relations Act (22 U.S.C. 254a-e); and International Organizations Immunities Act (22 U.S.C. 288e (a)).
PURPOSE: The principal purpose for the collection of this information is to notify the U.S. Department of State of the appointment of honorary consular
officers so the Department can therefore extend various privileges and benefits granted by the above-cited authorities which are predicated upon review
and acceptance of this information 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 as covered under STATE 36, Security Records. Information may also be provided to other
government agencies having statutory or other lawful authority to maintain such information. Names of the members of 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 semi-annually in Foreign Consular Offices in the United States, U.S. Department of State Publication 10277.
DISCLOSURE: Providing this information is mandatory. Failure to provide the information requested on this form may prevent acceptance and the
extension of benefits to principals or family members as provided in the above-cited authorities.
PRIVACY ACT and PAPERWORK REDUCTION ACT STATEMENTS
No Yes
Chief of Mission or Deputy
Date
(mm-dd-yyyy)
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dd mmm yyyy
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NOTIFICATION OF APPOINTMENT OF HONORARY CONSULAR OFFICER Form DS-2005

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Completed 15 May 2019

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