Durrani Law Firm, Ltd. :: Diversity Lottery Online Signup

Online Diversity Lottery Application

Durrani Law Firm is pleased to be able to process your Diversity Lottery Application online, for the low cost of $125.* Please fill out EACH field in its entirety, then proceed to the next page to check out. Our online payments are processed by PayPal. You DO NOT need a PayPal account to use this service.

Important Information:

The DV-2007 enrollment began on October 5th, 2005 and ends on December 4th, 2005. YOU MUST ENTER ALL YOUR INFORMATION AND SUBMIT A PAYMENT BY NOVEMBER 30TH, 2005 FOR YOUR CASE TO BE FILED.

Applicants are NOT ELIGIBLE if they are from Canada, China (mainland-born), Colombia, Dominican Republic, El Salvador, Haiti, India, Jamaica, Mexico, Pakistan, Philippines, Poland, 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.

Applicants must have a high school diploma or its equivalent (12-year course) or 2 years of work experience in the last five years in an occupation requiring at least 2 years of training or experience to perform.

Must have a recent individual photo of applicant, spouse, and all children under 21.

Instructions:

Please fill out this form in its entirety, making sure your information is 100% accurate.

After you click next, your information will be saved in our confidential database, and we will direct you to our payment page. The fee for this service is $125. There may be additional charges if your case requires special handling.

One of our legal assistants will contact you at the email address you provided to obtain any additional information necessary.

ALL information provided will not be shared with anyone for any other purposes but the processing of your Diversity Lottery application.

Your Information:
First Name:
Middle Name:
Last Name:
Address Line 1:
Address Line 2:
City, State, Postal Code:
Country
Email Address: NOTE: Your email address will be used as your login ID, and all correspondence will be sent to this address.
Verify Email:
Please Select a Password:
Verify Password:
Phone Number:
Gender / Marital Status
Number of Children Under 21, excluding children who are lawful U.S. Permanent Residents or Citizens.
Birth City & Country:
Your Spouse's Information - Please leave blank if not applicable. 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.
Spouse's First Name:
Spouse's Middle Name:
Spouse's Last Name:
Spouse's Birth City:
Spouse's Birth Country:
Spouse's Gender:
Your Children's Information - Please leave blank if not applicable. 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.
1st Child's First Name:
1st Child's Middle Name:
1st Child's Last Name:
1st Child's Gender
1st Child's Birth City:
1st Child's Birth Country:
Your Children's Information - Please leave blank if not applicable.
2nd Child's First Name:
2nd Child's Middle Name:
2nd Child's Last Name:
2nd Child's Gender
2nd Child's Birth City:
2nd Child's Birth Country:
Your Children's Information - Please leave blank if not applicable.
3rd Child's First Name:
3rd Child's Middle Name:
3rd Child's Last Name:
3rd Child's Gender
3rd Child's Birth City:
3rd Child's Birth Country:
Your Children's Information - Please leave blank if not applicable.
4th Child's First Name:
4th Child's Last Name:
4th Child's Gender
4th Child's Birth City:
4th Child's Birth Country:
CERTIFICATION: BY CLICKING "I AGREE," YOU AFFIRM THAT YOU HAVE READ, UNDERSTOOD, AND AGREED TO THE FOLLOWING: I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETELY TRUE AND ACCURATE AND UNDERSTAND THAT FEDERAL LAW PROVIDES FOR CIVIL AND CRIMINAL PENALTIES FOR PERJURY. I UNDERSTAND THAT MY CASE WILL NOT BE FILED UNLESS A PAYMENT HAS BEEN RECEIVED BY THE DURRANI LAW FIRM. I AGREE TO HOLD DURRANI LAW FIRM, LTD. AND ANY AGENTS THEREOF HARMLESS FOR ANY FALSE STATEMENTS CONTAINED HEREIN.