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ENTRY FORM FOR DV-2005

There is only one way to enter the DV-2005 lottery. Applicants must submit an Electronic Diversity Visa Entry Form (EDV Entry Form), which is accessible only at http://www.dvlottery.state.gov. Failure to complete the form in its entirety will disqualify the applicant’s entry.

The application form is prepared in two parts, one for the primary applicant and one for dependents (if any). Each part must be completed correctly and completely before going to the next part. After all parts are completed, the application will be submitted to the DV-2005 Processing Center for handling.

Applicants will be asked to submit the following information on the EDV Entry Form:

 
 
     
     
 

Part One - Applicant Information

 
     
 
  1. FULL NAME: Last/Family Name, First Name, Middle name  
 
     
     
     
 
  2. DATE OF BIRTH: Day, Month, Year  
 
     
     
     
 
  3. GENDER: Male or Female  
 
     
     
     
 
  4. CITY/TOWN OF BIRTH:  
 
     
     
     
 
  5. COUNTRY OF BIRTH: The name of the country should be that which is currently in use for the place where the applicant was born.  
 
     
     
     
 
  6. APPLICANT PHOTOGRAPH: The image must be in the Joint Photographic Experts Group (JPEG) File Interchange Format (JFIF) format. If the image is created by using a digital camera, it must have a resolution of 320 by 240 pixels, with either 24-bits of color, 8-bits of color or 8-bits of gray. If the image is created by scanning a photographic print the original print must have been 2" by 2" (50mm x 50mm), and the scan must be performed at a resolution of 150 dots per inch (dpi); the image must have a resolution of 300 by 300 pixels, with either 24-bits of color, 8-bits of color or 8-bits of gray. The image can not exceed 62,500 bytes (62.5KB) in size.

See instructions for more information.

 
 
     
     
     
 
  7. MAILING ADDRESS: Address, City/Town, District/Country/Province/State, Postal Code/Zip Code, Country  
 
     
     
     
 
  8. PHONE NUMBER: (optional)  
 
     
     
     
 
  9. E-MAIL ADDRESS: (optional)  
 
     
     
     
 
  10. COUNTRY OF ELIGIBILITY: If the applicant is claiming nativity in a country other than his/her place of birth, this information must be submitted on the entry.  
 
     
     
     
 
  11. MARRIAGE STATUS: Yes or No  
 
     
     
     
 
  12. NUMBER OF CHILDREN THAT ARE UNMARRIED AND UNDER 21 YEARS OF AGE:  
 
     
     
     
 

Part Two - Dependents (if any) Information

 
     
 
  13. SPOUSE INFORMATION: Name, Date of Birth, Gender, City/Town of Birth, Country of Birth, Photograph  
 
     
     
     
 
  14. CHILDREN INFORMATION: Name, Date of Birth, Gender, City/Town of Birth, Country of Birth, Photograph  
 
     
     
     
     
 
  NOTE: Entries must include the name, date and place of birth of the applicant’s spouse and all natural children, as well as all legally-adopted and stepchildren, who are unmarried and under the age of 21, excepting those children who are already U.S. citizens or Legal Permanent Residents, even if you are no longer legally married to the child’s parent, and even if the spouse or child does not currently reside with you and/or will not immigrate with you. Note that married children and children 21 years or older will not qualify for the diversity visa. Failure to list all children will result in your disqualification for the visa. (See question 11 on the list of Frequently Asked Questions.)  
 
     

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