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"DIVERSITY VISA ENTRY FORM"

Entry From in the Diversity Immigrant Visa Lottery Program
Prepared in compliance with U.S. DEPARTMENT OF STATE,
Bureau of Consular Affairs, Visa Bulletin No. 90, Vol. VII.
This"Entry Form" is prepared for Exclusive Use by Our Office.
Please be advised that we are NOT a Law Firm.

APPLICANT: DO NOT WRITE ON THIS PAGE EXCEPT YOUR SIGNATURE.
Our office uses this page to prepare your application under the federal rules and regulations.


	If I am selected, I authorize you to notify me at the following address:


	c/o


	Ghazali P.O. Box: 56505 Hayward, CA 94540


	Applicant´s Signature:__________________________________________

Cut photo to fit this box.

(37 mm x 37 mm)
Print your Name on back of Photo.
Attach Photo here by placing one piece of clear tape to the top edge of photo.


	If you are applying for a friend or relative overseas, You may send this Entry Form overseas by mail or fax for the Applicant to sign. Applicant may sign application and return to you by mail so that you can send to us.


	Before mailing forms to us, please cut photo to size and print name of Applicant on back of photo. Use just one small piece of clear tape to the box above.


	For us to complete your Entry Form, we must receive (no later than October 25, 1999) this signed form and photo, along with a completed "Application Questionnaire" and a check or money order for the correct Amount. Please mail early. Do not wait until the last minute.


	THIS FORM MAY BE COPIED

	*Click Here To Download Both Forms In Microsoft Word 97*