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Fill this form and then print it out. Then you can mail it to the following address (if you are Nepali Citizen): DV-2004 Program Kentucky Consular Center 2002 Visa Crest Migrate, KY 41902-2000, USA Submit the entry by regular or airmail to the address above.
The mail-in period for the next Diversity Visa lottery (DV-2003) will be held between noon on October 7, 2001 and noon on November 7, 2001.
Entries sent by express or priority mail, second day airmail, fax, hand, messenger, or any means requiring special handling will not be processed.
Information to Include in the Application There is no pre-printed government application form. Submit an application on a blank sheet of paper (or the sample form we have attached may be used) with the following information typed or printed clearly in the Roman (English) alphabet.
A. Full Name. Applicant’s full name, listed as last name, first name, middle name. Underline the last name, i.e., the surname or family name. B. Date and Place of Birth. Applicant’s date of birth (day/month/year) and place of birth (city/town, district/county/province, country). If the country name has changed, enter the name of the country currently in use for the country of birth. C. Country of Nativity/Chargeability. Applicant’s native country, if different from the country of birth. (See discussion regarding chargeability below.) If claiming nativity through a spouse or parent, the applicant should indicate this. D. Family Information. Name, date and place of birth of spouse and children who are unmarried and under age 21, including legally adopted children and stepchildren. All minor, unmarried children must be listed on the principal applicant’s entry, even if the applicant is no longer legally married to the child’s parent, and even if they do not wish to immigrate. (Note: Married children and children 21 years or older will not qualify for the Diversity Visa.) Failure to provide all of this information will disqualify the applicant. E. Mailing Information. Provide the applicant’s current mailing address. A telephone number is useful, but optional. F. Applicant’s Signature. The application will be disqualified if it is not personally signed by the applicant in his or her normal signature. Note that the signature should be the applicant’s usual and customary signature in his or her native alphabet. Neither an initialed signature nor block printing of the applicant’s name will be accepted. G. Photographs. Recent photographs of the applicant and dependent photographs, taken within the past six months, must be included, with the name and date of birth of each individual printed on the reverse of each photograph. The photographs must measure between 1-1/2 by 1-1/2 and 2 by 2 inches (37-50 mm) square in size. Photographs of the applicant’s spouse and all children, using the same size photos, must be included; the entry will be disqualified if photographs of all family members are not submitted. Group family photographs are not acceptable.
The person photographed must be looking directly at the camera and the head should not be tilted up, down, or to the side. The head should cover about 50% of the photo. Hats and other head coverings are not permitted except for religious beliefs, but in no case may the religious head covering obscure any portion of the face. Dark glasses are not permitted.
Photographs should be attached to the entry with clear tape, either to the front or back of the entry. Staples or paperclips should not be used, since they can jam the mail processing equipment.
H. Fees and multiple applications. No fee is required with a Diversity Visa Lottery application. Multiple applications are not permitted; if an individual applicant submits more than one application for him- or herself, he or she will be disqualified from registration.
Envelope Specifications Envelopes containing applications must be specifically marked. Each applicant must type or print legibly in the upper left hand corner the name of the country, of which he or she is a native, and his or her name and current address. All of this information must be typed or clearly printed in the English alphabet. Failure to include this information will cause the application to be disqualified.