DV Lottery Online Entry Form

Please write your details: Fill up all blanks and pay as required fee thru Web-ATM on the bottom of this page. We will reply within 48 hours.

1. FULL NAME Last Name: First Name:
2. DATE OF BIRTH:
3. GENDER: Male Female
4. CITY/TOWN OF BIRTH:
5. COUNTRY OF BIRTH:
6. APPLICANT PHOTOGRAPH - See Note 2 for information on photo specifications
7. MAILING ADDRESS:
8. PHONE NUMBER Home: Mobile:
9. E-MAIL ADDRESS:
10. COUNTRY OF ELIGIBILITY:
11. MARITAL STATUS: Unmarried Married Divorced Widowed Legally Separated
12. NUMBER OF CHILDREN THAT ARE UNMARRIED AND UNDER 21 YEARS OF AGE - Excludes Children who are US Permanent Residents or Citizens:
13. SPOUSE INFORMATION - Name, Date of Birth, Gender, City/Town of Birth, Country of Birth

14. CHILDREN INFORMATION - Name, Date of Birth, Gender, City/Town of Birth, Country of Birth
1st Child:
2nd Child:
3rd Child:
4th Child:

Note 1: For DV-2015, natives of the following countries are not eligible to apply because they sent a total of more than 50,000 immigrants to the U.S. in the previous five years:

CANADA, CHINA (mainland-born), COLOMBIA, DOMINICAN REPUBLIC, EL SALVADOR, HAITI, INDIA, JAMAICA, MEXICO, PAKISTAN, PHILIPPINES, RUSSIA, SOUTH KOREA, UNITED KINGDOM (except Northern Ireland) and its dependent territories, and VIETNAM. Persons born in Hong Kong SAR, Macau SAR and Taiwan are eligible.

On your entry you must list your spouse, that is husband or wife, and all unmarried children under 21 years of age, with the exception of children who are already U.S. citizens or Legal Permanent Residents. You must list your spouse even if you are currently separated from him/her, unless you are legally separated (i.e. there is a written agreement recognized by a court or a court order.) If you are legally separated or divorced, you do not need to list your former spouse. You must list ALL your children who are unmarried and under 21 years of age, whether they are your natural children, your spouse's children, or children you have formally adopted in accordance with the laws of your country, unless such child is already a U.S. citizen or Legal Permanent Resident. List all children under 21 years of age even if they no longer reside with you or you do not intend for them to immigrate under the DV program.

Note 2: Instructions for Submitting a Digital Photo (Image)

The image file must adhere to the following compositional specifications and technical specifications and can be produced in one of the following ways:

1. Taking a new digital image.

2. Using a digital scanner to scan a submitted photograph.

Compositional Specifications: The submitted digital image must conform to the following compositional specifications or the entry will be disqualified.

Head Position
Person being photographed must directly face the camera.
Head of the person should not be tilted up, down, or to the side.
Head of the person should cover about 50% of the area of the photo.
Background
Person being photographed should be in front of a neutral, light-colored background.
Dark or patterned backgrounds are not acceptable.
Focus
Photo must be in focus.
Decorative Items
Photos in which the person being photographed is wearing sunglasses or other items that detract from the face will not be accepted.
Head Coverings and Hats
Photos of applicants wearing head coverings or hats are only acceptable due to religious beliefs, and even then, may not obscure any portion of the face of the applicant.
Photos of applicants with tribal or other headgear not specifically religious in nature will not be accepted.
Photos of military, airline, or other personnel wearing hats will not be accepted.

Technical Specifications: The submitted digital photograph must conform to the following specifications or the system will automatically reject the EDV Entry Form and notify the sender.

1. Taking a New Digital Image. If a new digital image is taken, it must meet the following specifications:

Image File Format: The image must be in the Joint Photographic Experts Group (JPEG) format.

Image File Size: The maximum image file size will be 240 kilobytes.

Image Resolution: 600 pixels high by 600 pixels wide.

Image Color Depth: 24-bit color.

2. Scanning a Submitted Photograph. Before a photographic print is scanned, it must meet the following specifications:

Print Size: 2 inches by 2 inches (50mm x 50mm) square.

Print Color: The image must be in color.

The photographic print must also meet the Compositional Specifications. If the photographic print meets the Print Size, Print Color, and Compositional Specifications, scan the print using the following scanner specifications.

Scanner Resolution: Scanned at a resolution of at least 150 dots per inch (dpi).

Image File Format: The image must be in the Joint Photographic Experts Group (JPEG) format.

Image File Size: The maximum image file size will be 240 kilobytes.

Image Resolution: 600 by 600 pixels.

Image Color Depth: 24-bit color

Note 3: Please includes scanned copy of your passport, and passports of your spouse and children if you have. The address should be your permanent address where the winning visa lottery notification letter can be sent to.

Note 4: We charge a small amount consulting fee to enter your data onto the US Visa Lottery Registry. for single person: NTD2,000 and for a couple with children: NTD5,000. Please pay to us thru the link below. You must have Taiwan's bank card to pay, or you can call us to have alternative choice to pay.


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