INSTRUCTIONS FOR THE 2001 DIVERSITY IMMIGRANT VISA PROGRAM
The U.S. diversity immigration program makes available a maximum of 55,000* permanent residence visas each year to persons meeting the eligibility requirements. Applicants for diversity visas are initially chosen through a random computer-generated lottery drawing. Visas are apportioned among six geographic regions with a greater number of visas going to regions with lower rates of immigration, and no visas going to countries sending more than 50,000 immigrants to the U.S. in the past five years. No one country can receive more than seven percent of the available diversity visas in any one year. For DV-2001, natives of the following are not eligible to apply:
CANADA, CHINA (mainland and Taiwan, except Hong Kong S.A.R.), COLOMBIA, DOMINICAN REPUBLIC, EL SALVADOR, HAITI, INDIA, JAMAICA, MEXICO, PHILIPPINES, POLAND, SOUTH KOREA, UNITED KINGDOM (except Northern Ireland) and its dependent territories, and VIETNAM.
ENTRIES FOR THE DV-2001 DIVERSITY VISA LOTTERY MUST BE RECEIVED BETWEEN NOON ON MONDAY, OCTOBER 4, 1999 AND NOON ON WEDNESDAY, NOVEMBER 3, 1999. Entries received before or after these dates will be disqualified regardless of when they are postmarked. Also, entries sent to an incorrect address will be disqualified.
REQUIREMENTS: To enter, an applicant must be able to claim
nativity in an eligible country, AND must meet either the education
or training requirement of the DV program. Nativity in most cases
is determined by the applicant's place of birth. However, if a person was
born in an ineligible country but his/her spouse was born in an
eligible country, such person can claim the spouse's country of birth rather
than his/her own. Also, if a person was born in an ineligible country,
but neither of his/her parents was born there or resided
there at the time of the birth, such person may be able to claim nativity
in one of the parents' country of birth.
Education or Training: To enter, an applicant MUST have EITHER a high school education or its equivalent, defined in the U.S. as successful completion of a 12-year course of elementary and secondary education; OR two years of work experience within the past five years in an occupation requiring at least two years of training or experience to perform. U.S. Department of Labor definitions will apply. If a person does not meet these requirements, he/she should NOT submit an entry to the DV program.
PROCEDURES FOR SUBMITTING AN ENTRY FORM
Only ONE entry form may be submitted by or for each applicant during the registration period. Submission of more than one entry will disqualify the person. The applicant must personally sign the entry, preferably in his/her native alphabet. Failure of the applicant to personally sign his/her own entry will result in disqualification.
COMPLETING THE ENTRY FORM
There is no specific format for the entry. Simply use a plain sheet of paper and type or clearly print in the English alphabet (preferably in the following order):
*The Nicaraguan and Central American Relief Act
(NCARA) passed by Congress in November 1997 stipulates that beginning with
DV-99, and for as long as necessary, 5,000 of the 55,000 annually-allocated
diversity visas will be made available for use under the NCARA program.
ON A PLAIN SHEET OF PAPER INCLUDE:
The following information must appear on the entry. Failure to provide
all of this information will disqualify the applicant.
1. FULL NAME, with the last (surname/family) name underlined
EXAMPLES: Public, Sara Jane (or) Lopez, Juan Antonio
2. DATE AND PLACE OF BIRTH
Date: Day, Month, Year
EXAMPLE: 15 November 1961
Place: City/Town, District/County/Province, Country
EXAMPLE: Munich, Bavaria, Germany
The name of the country should be that which is currently in use for the place where the applicant was born (Slovenia, rather than Yugoslavia; Kazakstan rather than Soviet Union, for example).
3. THE APPLICANT'S NATIVE COUNTRY IF DIFFERENT FROM COUNTRY OF BIRTH
If the applicant is claiming nativity in a country other than his/her place of birth, this must be clearly indicated on the entry. This information must match with what is put on the upper left corner of the entry envelope. (See "MAILING THE ENTRY" below.) If an applicant is claiming nativity through spouse or parent, please indicate this on the entry. (See "REQUIREMENTS" section on page 1 for more information on this item.)
4. NAME, DATE AND PLACE OF BIRTH OF THE APPLICANT'S SPOUSE AND CHILDREN (IF ANY) Failure to provide all of this information will disqualify the applicant. (see question 10 on the list of Frequently Asked Questions)
5. FULL MAILING ADDRESS
This must be clear and complete, as any communications will be sent there. A telephone number is optional, but useful.
6. PHOTOGRAPH. Attach a recent, preferably less than 6 months old, photograph of the applicant, 1.5 inches (37 mm) square in size, with the applicant's name printed on the back. The photograph (not a photocopy) should be attached to the entry with clear tape--do NOT use staples or paperclips, which can jam the mail processing equipment.
7. SIGNATURE. Failure to personally sign the entry will disqualify the applicant.MAILING THE ENTRY
Submit the entry by regular or air mail to the address matching the region of the applicant's country of nativity. Entries sent by express or priority mail, fax, hand, messenger, or any means requiring receipts or special handling will not be processed.
The envelope must be between 6 and 10 inches (15 to 25 cm) long
and 3 1/2 and 4 1/2 inches (9 to 11 cm) wide. Postcards are NOT
acceptable, nor are envelopes inside express or oversized mail packets.
In the upper left hand corner of the envelope the applicant must show his/her
country of nativity (see instruction 3 above), followed by the applicant's
name and full return address. The applicant must provide both the
country of nativity and the country of the address, even if both are the
same. Failure to provide this information will disqualify the entry.
The mailing address for all entries is the same, except for the ZIP
(POSTAL) CODE. The address is:
DV-2001 ProgramUse the correct ZIP (POSTAL) CODE for the applicant's region of nativity. For the DV program, the regions are divided as follows: Africa includes all countries on the African continent and adjacent islands; Asia extends from Israel to the northern Pacific islands, and includes Indonesia; Europe extends from Greenland to Russia, and includes all countries of the former USSR; North America includes the Bahamas; Oceania includes Australia, New Zealand, Papua New Guinea and all countries and islands of the South Pacific; South America/Central America/Caribbean extends from Central America (Guatemala) and the Caribbean nations to Chile.
National Visa Center
Portsmouth, NH ZIP CODE (see list of zip codes to follow)
The ZIP (POSTAL) CODES
EXAMPLE: An applicant who was born in Australia and now
lives in France may submit one entry to the appropriate Zip (postal) code
for Oceania; the envelope should look like this:
Australia Applicant's Full Name (3 1/2" - 4 1/2" Street Address or City, Province, Postal Code 9 cm - 11 cm France in width) DV-2001 Program National Visa Center Portsmouth, NH (see above for appropriate zip) U.S.A.(If, for instance, the applicant's country is Australia (in Oceania), the Zip (postal) code for Australia would be used, that is, 00214.)
Registrants will be selected at random by computer from among all qualified entries. Those selected will be notified by mail during April to July 2000 and will be provided further instructions, including information on fees connected with immigration to the U.S. Persons not selected will NOT be notified. U.S. embassies and consulates will not be able to provide a list of successful applicants. Spouses and unmarried children of successful applicants under age 21 may also apply for visas to accompany or follow to join the principal applicant. DV-2001 visas will be issued between October 1, 2000 and September 30, 2001.
Applicants must meet ALL eligibility requirements under U.S. law in order to be issued visas.
Processing of applications and issuance of diversity visas to successful applicants and their eligible family members MUST occur by September 30, 2001. Family members may not obtain diversity visas to follow to join the applicant in the U.S. after this date.
Important Notice: There is NO initial
fee, other than postage, required to enter the DV-2001 program. The use
of an outside intermediary or assistance to prepare a DV-2001 entry is
entirely at the applicant's discretion. Qualified entries received directly
from applicants or through intermediaries have equal chances of being selected
by computer. There is no advantage to mailing early, or mailing
from any particular locale. Every application received during the mail-in
period will have an equal random chance of being selected within its region.
However, more than one application per person will disqualify the person
"Native" ordinarily means someone born within a particular country, regardless of the individual's current country of residence or nationality.
"Native" also means someone entitled to be "charged" to a particular country under the provisions of Section 202(b) of the Immigration and Nationality Act. Applicants for DV-2001 registration may under Section 202(b) claim chargeability to the country of birth of a spouse; a minor dependent child can be charged to the country of birth of a parent; and an applicant born in a country of which neither parent was a native or a resident at the time of his/her birth may be charged to the country of birth of either parent. An applicant who claims the benefit of alternate chargeability must include information to that effect on the application for registration (see number 3 of the application information items under "On a Plain Sheet of Paper Include" in this Visa Bulletin), and must show the native country claimed on the upper left hand corner of the envelope in which the registration request is mailed.
2. ARE THERE ANY CHANGES OR NEW REQUIREMENTS IN THE APPLICATION PROCEDURES FOR THIS DIVERSITY VISA REGISTRATION?
The requirements for this DV registration are the same as for the last registration. The information required on the application and on the envelope in which it is submitted is specified in detail earlier in this Visa Bulletin. Each application must be signed by the applicant, and a recent photograph of the applicant must be attached. The applicant's name must be printed on the back of the photograph.
3. ARE SIGNATURES AND PHOTOGRAPHS REQUIRED FOR EACH FAMILY MEMBER, OR ONLY FOR THE PRINCIPAL APPLICANT?
The signature and photograph of the principal applicant only are required. NO SIGNATURE OR PHOTOGRAPH IS NEEDED FOR THE SPOUSE OR CHILD(REN) OF A PRINCIPAL APPLICANT.
4. WHY DO CERTAIN COUNTRIES NOT QUALIFY FOR THE DIVERSITY PROGRAM?
Diversity visas are intended to provide an immigration opportunity for persons from countries other than the main source countries of immigration to the U.S. The law states that no diversity visas shall be provided for "high admission" countries, that is, countries from which during the previous five years there were more than 50,000 immigrants in the Family-Sponsored and Employment-Based visa categories. Each year, the Immigration and Naturalization Service (INS) adds the family and employment immigrant admission figures for the previous five years, to identify the countries which must be excluded from the annual diversity lottery. Because there is a separate determination made prior to each lottery application period, the list of countries which do not qualify is subject to change from one year to the next.
5. WHAT ARE THE REGIONAL DIVERSITY (DV) VISA LIMITS FOR DV-2001?
The INS determines the DV regional limits for each year according to a formula specified in Section 203(c) of the Immigration and Nationality Act (INA). Once the INS has completed the calculations, the DV-2001 the regional visa limits will be announced.
Because most immigrant visas in other categories go to persons from Asia and the Western Hemisphere, those regions receive only a small number of the diversity visas. Persons from Africa, Europe and Oceania, who receive fewer visas in other categories, are provided the major part of the diversity visas.
6. WHEN WILL THE REGISTRATION FOR THE DV LOTTERY BE HELD EACH YEAR?
The month long registration period will be held each Fall beginning at noon on the first Monday in October. The National Visa Center receives between 7 to 8 million qualified entries during a registration mail-in period. The massive volume of entries creates an enormous amount of work in selecting and processing successful registrants. Holding the registration period in the Fall will ensure successful registrants are notified in a more timely manner. This will give both them and our Embassies and Consulates overseas more time to prepare and complete the applications for visa issuance.
7. MAY PERSONS WHO ARE IN THE U.S. APPLY FOR REGISTRATION?
Yes, an applicant may be in the U.S. or in another country, and the application may be mailed in the U.S. or abroad.
8. IS EACH APPLICANT LIMITED TO ONLY ONE APPLICATION DURING THIS DV-2001 REGISTRATION PERIOD?
Yes, the law allows only ONE application BY OR FOR each person during each registration period; SUBMISSION OF MORE THAN ONE APPLICATION WILL DISQUALIFY THE PERSON FROM REGISTRATION. Applicants may be disqualified at time of registration or at the time of the visa interview if more than one entry is detected. Submission of an application during one or more previous DV registrations has no effect on entitlement to participate in the DV-2001 lottery, however.
9. MAY A HUSBAND AND A WIFE EACH SUBMIT A SEPARATE APPLICATION?
Yes, if otherwise qualified, a husband and a wife may each submit one application for registration; if either is registered, the other would be entitled to derivative status. Note: They may not sign for each other, i.e. the husband must sign his application and the wife must sign hers.
10. WHAT FAMILY MEMBERS MUST I BE SURE TO INCLUDE ON MY ENTRY?
On your entry you must list your spouse, that is husband or wife, and all children who are unmarried and under age 21. You must list your spouse even if you are currently separated from him/her; if you are formally divorced, you do not need to list your former spouse. For customary marriages, the important date is the date of the original marriage ceremony, not the date on which the marriage is registered. You must list all your unmarried children under age 21, whether they are your natural children, your spouse's children by a previous marriage, or children you have formally adopted in accordance with the laws of your country. Even children in the above categories who are not currently living with you must be listed.
The fact that you have listed family members on your entry does not mean that they later must travel with you. They may choose to remain behind. However, if you include an eligible dependent on your application forms whom you failed to include on your original entry, your case will be disqualified. (This only applies to persons who were dependents at the time the original application was submitted, not those acquired at a later date.) Listing ineligible persons (a brother or sister, a child over 21, a child living with you but not formally adopted, etc.) on your entry will not disqualify the entry, but neither will it make such persons eligible for a visa. Your spouse may still submit a separate entry, even though he or she is listed on your entry, as long as both entries include details on all dependents in your family. See question 9 above.
11. MUST EACH APPLICANT SUBMIT HIS/HER OWN REQUEST, OR MAY SOMEONE ACT ON BEHALF OF AN APPLICANT?
Applicants may prepare and submit their own request for registration, or have someone act on their behalf. Regardless of whether an application is submitted by the applicant directly, or assistance is provided by an attorney, friend, relative, etc., ONLY ONE APPLICATION MAY BE SUBMITTED IN THE NAME OF EACH PERSON. The applicant's original signature is required on the application, regardless whether it is prepared and submitted by the applicant or by someone else. Only one notification letter will be sent for each case registered, to the address provided on the application.
12. WHAT ARE THE REQUIREMENTS FOR EDUCATION OR WORK EXPERIENCE?
The law and regulations require that every applicant must have at least a high school education or its equivalent or, within the past five years, have two years of work experience in an occupation requiring at least two years training or experience. A "high school education or equivalent" is defined as successful completion of a twelve-year course of elementary and secondary education in the United States or successful completion in another country of a formal course of elementary and secondary education comparable to a high school education in the United States. Determination of qualifying work experience shall be based upon the most recent edition of the Dictionary of Occupational Titles published by the Employment and Training Administration of the United States Department of Labor.
Documentary proof of education or work experience should NOT be submitted with the lottery application, but must be presented to the consular officer at the time of immigrant visa interview.
13. HOW WILL CASES BE REGISTERED?
At the National Visa Center all mail received will be separated into one of six geographic regions and individually numbered. After the end of the application period, a computer will randomly select cases from among all the mail received for each geographic region. Within each region, the first letter randomly selected will be the first case registered, the second letter selected the second registration, etc. It makes no difference whether an application is received early or late in the application period; all applications received during the mail-in period will have an equal chance of being selected within each region. When a case has been registered, the applicant will immediately be sent a notification letter by the National Visa Center, which will provide appropriate visa application instructions. The National Visa Center will continue to process the case until those who are registeredare instructed to make formal application at a U.S. consular office or until those able to do so apply at an INS office in the United States for change of status.
14. MAY REGISTERED APPLICANTS ADJUST THEIR STATUS WITH THE INS?
Yes, provided they are otherwise eligible to adjust status under the terms of Section 245 of the INA, registered applicants who are physically present in the United States may apply to the Immigration and Naturalization Service (INS) for adjustment of status to permanent resident. Applicants must ensure that INS can COMPLETE ACTION on their cases before September 30, 2001, since on that date registrations for the Fiscal Year 2001 DV-2001 program expire.
15. WILL APPLICANTS WHO ARE NOT REGISTERED BE INFORMED?
No, applicants who are not registered will receive no response to their registration request. Only those who are registered will be informed. All notification letters are expected to be sent within about six months of the end of the application period. Anyone who does NOT receive a letter will know that his/her application has not been registered.
16. HOW MANY APPLICANTS WILL BE REGISTERED?
There are a maximum of 55,000 DV visas available for Fiscal Year 2001 but more than that number of individuals will be registered. A total of about 100,000 persons, both principal applicants and their spouses and children, will be registered. Since it is likely that some of the first 50,000 persons who are registered will not pursue their cases to visa issuance, this larger figure should ensure use of all DV-2001 numbers, but it also risks some registrants being left out. All applicants who are registered will be informed promptly of their place on the list. Each month visas will be issued, visa number availability permitting, to those applicants who are ready for issuance during that month. Once all of the Fiscal Year 2001 visas have been issued, the program for the year will end. In principle, visa numbers could be exhausted before September 2001. Registered applicants who wish to receive visas must be prepared to ACT PROMPTLY on their cases. Being selected as a winner in the DV lottery does not automatically guarantee a visa.
17. IS THERE A MINIMUM AGE FOR APPLICANTS FOR REGISTRATION UNDER THE DV-2001 PROGRAM?
There is NO minimum age for submission of an application for registration, but the requirement of a high school education or work experience for each principal applicant at the time of entry registration will effectively disqualify most persons who are under age 18.
18. WILL THERE BE ANY SPECIAL FEE FOR DV-2001 CASE PROCESSING?
There is NO FEE FOR SUBMITTING A REQUEST FOR REGISTRATION, and NO FEE should be included with the letter sent to the mailing addresses indicated above. A special DV case processing fee will be payable later by persons whose applications are actually selected and processed for DV-2001 visas. DV-2001 applicants, like all other immigrant visa applicants, must also pay the regular visa fees at the time of visa issuance. Details of required fees will be included with the visa application instructions sent to applicants whose cases are registered.
19. ARE DV-2001 APPLICANTS SPECIALLY ENTITLED TO APPLY FOR A WAIVER OF ANY OF THE GROUNDS OF VISA INELIGIBILITY?
No. Applicants are subject to all grounds of ineligibility specified in the Immigration and Nationality Act and there are no special provisions for the waiver of any ground of visa ineligibility other than those ordinarily provided in the Act.
20. MAY PERSONS WHO ARE ALREADY REGISTERED FOR AN IMMIGRANT VISA IN ANOTHER CATEGORY APPLY IN THIS REGISTRATION FOR THE DV-2001 CATEGORY?
Yes, such persons may seek DV-2001 status through this registration as well.
21. HOW LONG DO APPLICANTS WHO ARE REGISTERED ON THE BASIS OF THIS DIVERSITY LOTTERY REMAIN ENTITLED TO APPLY FOR VISAS IN THE DV-2001 CATEGORY?
Under the law, persons registered following the DV-2001 lottery are entitled to apply for visa issuance ONLY DURING FISCAL YEAR 2001, i.e., from October 2000 through September 2001. There is no carry-over of DV benefit into another year for persons who are registered but who do not obtain visas during FY-2001. Similarly, spouses and children who derive status from a DV-2001 registration can only obtain visas in the DV category between October 2000 and September 2001.
LISTS OF QUALIFYING COUNTRIES BY REGION
The lists below show the countries QUALIFIED within each geographic region for this diversity program. The determination of countries within each region is based on information provided by the Geographer of the Department of State. The countries which do not qualify for the DV-2001 program were identified by the Immigration and Naturalization Service according to the formula in Section 203(c) of the Immigration and Nationality Act. Dependent areas overseas are included within the region of the governing country. The countries which do NOT qualify for this diversity program (because they are the principal source countries of Family-Sponsored and Employment-Based immigration) are noted in parentheses after the respective regional lists.
ALGERIA EGYPT ANGOLA EQUATORIAL GUINEA BENIN ERITREA BOTSWANA ETHIOPIA BURKINA FASO GABON BURUNDI GAMBIA, THE CAMEROON GHANA CAPE VERDE GUINEA CENTRAL AFRICAN REPUBLIC GUINEA-BISSAU CHAD KENYA COMOROS LESOTHO CONGO LIBERIA CONGO, DEMOCRATIC LIBYA REPUBLIC OF THE MADAGASCAR COTE D'IVIORE (IVORY COAST) MALAWI DJIBOUTI MALI MAURITANIA SIERRA LEONE MAURITIUS SOMALIA MOROCCO SOUTH AFRICA MOZAMBIQUE SUDAN NAMIBIA SWAZILAND NIGER TANZANIA NIGERIA TOGO RWANDA TUNISIA SAO TOME AND PRINCIPE UGANDA SENEGAL ZAMBIA SEYCHELLES ZIMBABWEASIA
AFGHANISTAN LAOS BAHRAIN LEBANON BANGLADESH MALAYSIA BHUTAN MALDIVES BRUNEI MONGOLIA BURMA NEPAL CAMBODIA OMAN HONG KONG SPECIAL PAKISTAN ADMINISTRATIVE REGION QATAR INDONESIA SAUDI ARABIA IRAN SINGAPORE IRAQ SRI LANKA ISRAEL SYRIA JAPAN THAILAND JORDAN UNITED ARAB EMIRATES NORTH KOREA YEMEN KUWAIT(Asia countries which do not qualify for this year's diversity program: CHINA - mainland born and Taiwan born, INDIA, SOUTH KOREA, PHILIPPINES, and VIETNAM.) [The HONG KONG S.A.R. does qualify and is listed above.] Macau's eligibility for participation in the DV lottery will be determined by legislation that has not been passed into law at the time of Visa Bulletin publication.
ALBANIA LITHUANIA ANDORRA LUXEMBOURG ARMENIA MACEDONIA, THE FORMER AUSTRIA YUGOSLAV REPUBLIC OF AZERBAIJAN MALTA BELARUS MOLDOVA BELGUIM MONACO BOSNIA AND HERZEGOVINA MONTENEGRO BULGARIA NETHERLANDS CROATIA including components and CYPRUS dependent areas overseas CZECH REPUBLIC NORTHERN IRELAND DENMARK NORWAY including components and PORTUGAL dependent areas overseas including components and ESTONIA dependent areas overseas* FINLAND ROMANIA FRANCE RUSSIA including components and SAN MARINO dependent areas overseas SERBIA GEORGIA SLOVAKIA GERMANY SLOVENIA GREECE SPAIN HUNGARY SWEDEN ICELAND SWITZERLAND IRELAND TAJIKISTAN ITALY TURKEY KAZAKSTAN TURKMENISTAN KYRGYZSTAN UKRAINE LATVIA UZBEKISTAN LICHTENSTEIN VATICAN CITY(European countries not qualified for this year's diversity program: GREAT BRITAIN and POLAND. GREAT BRITAIN (UNITED KINGDOM) includes the following dependent areas: ANGUILLA, BERMUDA, BRITISH VIRGIN ISLANDS, CAYMAN ISLANDS, FALKLAND ISLANDS, GIBRALTAR, MONTSERRAT, PITCAIRN, ST. HELENA, TURKS AND CAICOS ISLANDS. Note that for purposes of the diversity program only, Northern Ireland is treated separately; Northern Ireland does qualify and is listed among the qualifying areas.
(In North America, CANADA does not qualify for this year's diversity program.)
AUSTRALIA NEW ZEALAND including components and including components and dependent areas overseas dependent areas overseas FIJI PALAU KIRIBATI PAPUA NEW GUINEA MARSHALL ISLANDS SOLOMON ISLANDS MICRONESIA, FEDERATED TONGA STATES OF TUVALU NAURU VANUATU WESTERN SAMOASOUTH AMERICA, CENTRAL AMERICA, AND THE CARIBBEAN
ANTIGUA AND BARBUDA HONDURAS ARGENTINA NICARAGUA BARBADOS PANAMA BELIZE PARAGUAY BOLIVIA PERU BRAZIL SAINT KITTS AND NEVIS CHILE SAINT LUCIA COSTA RICA SAINT VINCENT AND CUBA THE GRENADINES DOMINICA SURINAME ECUADOR TRINIDAD AND TOBAGO GRENADA URUGUAY GUATEMALA VENEZUELA GUYANA(Countries in this region which do not qualify for this year's diversity program: COLOMBIA, DOMINICAN REPUBLIC, EL SALVADOR, HAITI, JAMAICA, and MEXICO.)
CA/VO: August 2, 1999
As stated on page 1 there is no specific format for the DV entry form. The following sample form is provided to help facilitate the entry process, but other formats may be used. SEE THE INFORMATION UNDER "ON A PLAIN SHEET OF PAPER INCLUDE" IN THIS BULLETIN FOR SPECIFIC DETAILS/EXAMPLES OF HOW THIS (OR ANY OTHER) FORM SHOULD BE FILLED OUT. Failure to provide all of the required information will disqualify the applicant. 1. FULL NAME:______________________________ ________________________ LAST (surname/family) FIRST 2. DATE OF BIRTH: ____________________________ Day, Month, YearPLACE OF BIRTH: ________________________________________________________ City/Town, District/County/Province, Country 3. APPLICANT'S NATIVE COUNTRY IF DIFFERENT FROM COUNTY OF BIRTH: _______________________________________________________________ (See "REQUIREMENTS" section for more information on this item.)
4. NAME, DATE AND PLACE OF BIRTH OF THE APPLICANT'S SPOUSE AND CHILDREN (IF ANY) _______________________ ____________________ _____________________ Name Date of birth Place of birth (day,month,year) _______________________ ____________________ _____________________ Name Date of birth Place of birth (day,month,year) Attach information on additional child(ren) as necessary. 5. FULL MAILING ADDRESS:___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ____________________________ 6. PHOTOGRAPH: (Attach a recent, preferably less than 6 months old, photograph of the applicant, 1.5 inches (37 mm) square in size, with the applicant's name printed on the back. The photograph (not a photocopy) should be attached to the entry with clear tape--do NOT use staples or paperclips, which can jam the mail processing equipment.)
7. SIGNATURE: ________________________________________________________
Failure to personally sign the entry will disqualify the applicant.