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DS-5501 Electronic Diversity Visa Entry Form, Part Two

ICR 200608-1405-001 · OMB 1405-0153 · Object 112701.

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ELECTRONIC DIVERSITY VISA ENTRY FORM

Approved OMB 1405-0153
Expires: 04/30/2007
Estimated Burden: 30 minutes

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Part Two - Dependents

13. Spouse Name

a. Last/Family Name

 No Last/Family Name

b. First Name

 No First Name

c. Middle Name

 No Middle Name

13d. Birth Date

13e. Gender

Male

Female

 

13f. Birth City


Birth City/Town Unknown

13g. Birth Country

13h. Spouse Photograph

Please refer to the Instructions for the 2007 Diversity Immigrant Visa Program (DV-2007) for technical specifications and compositional specifications for the digital image. You will use one of the following methods to enter the image into eDV:

  • Take a new digital image.

  • Use a digital scanner to scan a submitted photograph.

Specific instructions are included for both methods.

Photograph File Name

If you know the location in the computer and the name of the file which is storing the photograph, enter it in the box to the left of(the) 'Browse' button. If you are not sure of the location in the computer or the name of the file, clicking the 'Browse' button will allow you to look for and choose the file which is storing the photograph, and after you choose the file its name will appear in the box on the left.

14. Child #1 Name

a. Last/Family Name

 No Last/Family Name

b. First Name

 No First Name

c. Middle Name

 No Middle Name

14d. Birth Date

14e. Gender

Male

Female

 

14f. Birth City


Birth City/Town Unknown

14g. Birth Country

14h. Child Photograph

Please refer to the Instructions for the 2007 Diversity Immigrant Visa Program (DV-2007) for technical specifications and compositional specifications for the digital image. You will use one of the following methods to enter the image into eDV:

  • Take a new digital image.

  • Use a digital scanner to scan a submitted photograph.

Specific instructions are included for both methods.

Photograph File Name

If you know the location in the computer and the name of the file which is storing the photograph, enter it in the box to the left of(the) 'Browse' button. If you are not sure of the location in the computer or the name of the file, clicking the 'Browse' button will allow you to look for and choose the file which is storing the photograph, and after you choose the file its name will appear in the box on the left.

DS-5501

PAPERWORK REDUCTION ACT

*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, D.C. 20520.

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Copyright Information


File Typeapplication/msword
File Title DS-5501 Electronic Diversity Visa Entry Form, Part Two
AuthorAlexanderBH
Last Modified ByDoS CA
File Modified2006-07-19
File Created2006-07-19