WORKSHEETS-CHECKLISTS

Form DS-260 IV Application
Sign In Page

Select Principal Applicant and enter your Case Number.

Form DS-260 is Applicant Sensitive. Questions are based on your age and gender, the country where you were born, where you are located now, etc. Questions will also differ based on answers given.

All family members must complete a Form DS-260. They must select Derivative Applicant and enter the (same) Case Number. A parent can complete the form for a child younger than 14.

You must have your photo ready for upload. Check whether the digital image meets DOS requirements before you start your application.

Personal Information

The information you give must match (be the same) as it is written in your Passport !

• Surname(s)

Type name(s) in the answer box

• Given Name(s)

Type name(s) in the answer box

• Your Full Name in your Native Alphabet

Type it in the answer box
Click Does Not Apply when your name is written in Latin characters
Click Technology Not Available when you have no option to enter your name in non-Latin characters

Q. Have you ever used other names ?

Click Yes or No
If Yes you must give:
• Other Surnames Used
• Other Given Names Used
Answer boxes can be added as needed

• Date of Birth

Enter in the format DD-MM-YYYY
Date and Month must be entered using pull-down menus
The year must be typed in the answer box

• City of Birth

Type in the answer box

• State/Province of Birth

Type in the answer box or click the box Does Not Apply

• Country/Region of Birth

Enter using the pull-down menu

• Nationality

Enter using the pull-down menu

• Document type

Select from pull-down menu
(Passport)

• Document ID

Type number in answer box

• Country/Authority that issued

Select form pull-down menu

• Issuance Date

Enter in the format DD-MM-YYYY
Date and Month must be entered using pull-down menus
The year must be typed in the answer box

• Expiration Date

Enter in the format DD-MM-YYYY
Date and Month must be entered using pull-down menus.
The year must be typed in the answer box

Q. Do you hold of have you held any other nationality ?

Click Yes or No
If Yes the Other Nationality must be entered using a pull-down menu

Q. Do you hold a passport for the other nationality ?

Click Yes or No
If Yes information about that passport must be given

Present and Previous Address Information

• Present Address (where you live now)
• Street Address (line 1)

Type the name of the street or the road in the answer box

• Street Address (line 2)

This line is OPTIONAL – you can leave the box empty
Use it when your address does not fit on line 1

• City

Type the name in the answer box

• State/Province

Type the name in the answer box or click the box Does Not Apply

• Postal Zone/ZIP Code

( This is a code postal services in many countries attach to addresses)
Type the characters in the box or click Does Not Apply

• Country/Region

Enter using the pull-down menu

• From Date

Give the date you moved into your current home using a pulldown menu for the Month and type the Year in the answer box

Q. Have you lived anywhere else since the age of 16 ?

(Do not give short-stay or vacation addresses)
Click Yes or No
If Yes you must enter the other address(es)

• Phone Number Primary

Type the number in the answer box

• Secondary Phone Number

Type the number in the box or click Does Not Apply

• Work Phone Number

Type the number in the box or click Does Not Apply

• Email Address

Type the address in the answer box

Mailing and Permanent Address Information

Q. Is your Mailing Address the same as your Present Address ?

Click Yes to No
If No you must give your Mailing Address

Q. Do you have an address in the U.S. ?

Click Yes or No
If Yes you must give the address

Q. Is this the address where you want the Green Card mailed ?

Click Yes or No
If No you must enter another U.S. address

Family Information: Parents Page
(Information either on your biological or your adoptive parents)

• Surname(s) Father

Enter the name(s) in the box or click the box Do Not Know

• Given Name(s) Father

Enter the name(s) in the box or click the box Do Not Know

• Date of Birth Father

Enter in the format DD-MM-YYYY or click Do Not Know
Date and Month must be entered using pull-down menus
The year must be typed in the answer box

• City of Birth Father

Type in the answer box or click Do Not Know

• State/Province of Birth Father

Type in the answer box or click Do Not Know

• Country/Region of Birth Father

Enter using the pull-down menu or click Do Not Know

Q. Is your father still living ?

Click Yes or No
If No you must give Year of Death
If Yes you must give his current address or click Do Not Know

• Surname(s) Mother

Enter the name(s) in the box or click the box Do Not Know

• Given Name(s) Mother

Enter the name(s) in the box or click the box Do Not Know

• Date of Birth Mother

Enter in the format DD-MM-YYYY or click Do Not Know
Date and Month must be entered using pull-down menus
The year must be typed in the answer box

• City of Birth Mother

Type in the answer box or click Do Not Know

• State/Province of Birth Mother

Type in the answer box or click Do Not Know

• Country/Region of Birth Mother

Enter using the pull-down menu or click Do Not Know

Q. Is your mother still living ?

Click Yes or No
If No you must give Year of Death
If Yes you will be asked if mother’s address is the same as father’s

Click Yes or No
If No must give mother’s current address or click Do Not Know

Family Information: Spouse
• Surname(s) Current Spouse

Type name(s) in the answer box

• Given Name(s) Current Spouse

Type name(s) in the answer box

• Date of Birth Current Spouse

Enter in the format DD-MM-YYYY
Date and Month must be entered using pull-down menus
The year must be typed in the answer box

• City of Birth Current Spouse

Type in the answer box or click Do Not Know

• State/Province of Birth Current Spouse

Type in the answer box or click Does Not Apply

• Country/Region of Birth Current Spouse

Enter using the pull-down menu

• Current Spouse’s Address

Enter using the pull-down menu
either Same as Present Address or Other
If Other you must give your spouse’s current address

• Current Spouse’s Occupation

Enter using the pull-down menu
If Not Employed you must provide an explanation in the answer box
If Other you must provide an explanation

• Date of Marriage

Enter in the format DD-MM-YYYY
Date and Month must be entered using pull-down menus
The year must be typed in the answer box

• City where you were married

Type the name in the answer box

• State/Province

Type in the answer box or click Does Not Apply

• Country/Region

Enter using the pull-down menu

• Q. Is you spouse immigrating to the U.S. with you ?

Click Yes or No

• Q. Is your spouse immigrating to the U.S. at a later date to join you ?

This option is not for DV Winners – Click No

Family Information: Previous Spouse(s)

Q. Do you have any previous spouses ?

Click Yes or No
If Yes you must give the Number of Previous Spouses

You must provide for each:
• Surname(s)
• Given Name(s)
• Date of Birth
• Date of Marriage
• Date Marriage Ended
• Country/Region where Marriage was Terminated

Answer How was Marriage Terminated ? with an explanation

Answer boxes can be added

Family Information: Children
Include here biological children, step children, adopted children, even if they are over 21 years of age (and not eligible to immigrate with you).

Q. Do you have any children ?

Click Yes or No
If Yes you must give the Number of Children

You must provide for each:
• Surname(s)
• Given Name(s)
• Date of Birth
• Place of Birth
City
State/Province
Country/Region

Q. Does this child live with you ?

Click Yes or No

Q. Is this child immigrating to the U.S. with you ?

Click Yes or No
If No you will be asked: Is this child immigrating at a later date to join you ?
This option is not for DV Winners – Click No

Answer boxes can be added

Previous U.S. Travel Information

Q. Have you ever been to the U.S. ?

Click Yes or No
If Yes you will be asked if you were issued an Alien Registration Number.

Click Yes or No
If Yes you must give your A Number or click Do Not Know

You must also give information about your last five U.S. visits
• Date Arrived in format DD-MM-YYYY
• Length of Stay

Answer boxes can be added

Q. Have you ever been issued a U.S. Visa ?

Click Yes or No
If Yes you must give information about your last visa
• Date issued in format DD-MM-YYYY
• Classification (pull-down menu) or click Do Not Know
• Visa Number or Do Not Know
Q. Have any of your visas ever been lost our stolen ?
click Yes or No – if Yes you must give the year and explain

Q. Have any of your visas been cancelled or revoked ?

click Yes or No – if Yes you must explain

Q. Have you ever been refused a U.S. Visa, been refused admission to the U.S., or have you ever withdrawn your application for admission at Port of Entry ?

(POE is the first place where you arrive when traveling to the U.S.)

Click Yes or No
If Yes you must provide an explanation

Present Work/Education/Training Information
(Information current employment or education – only for applicants 14 and over)

• Primary Occupation

Select from a pull-down menu
If Other you must provide a specification
If Not Employed you must give an explanation
(Homemaker – stay-at-home spouse/parent – and Retired are possible answers)

• Add Occupation Information:
• Present Employer
• Address of Employer
(Street, City, State/Province, Postal Zone/ZipCode, Country/Region, telephone number)
• Job Title, Name Supervisor, employment start and end date

Q. Do you have other occupations ?

Click Yes or No
If Yes Information must be added same as for Primary Occupation

• Add Education Information
• Name School
• Address of School
(Street, City, State/Province, Postal Zone/ZipCode, Country/Region, telephone number)
• Course of Study, Degree/Diploma, attendance start and end date

• In which occupation do you intend to work in the U.S. ?
Select from the pull-down menu
If Other you must specify
If Not Employed you must explain
(Homemaker and Retired are possible answers)

Previous Work/Education/Training Information
(In case previous Homemaker or Retired were selected)

Q. Were you previously employed ?

Click Yes or No
If Yes you must complete information about previous employer(s) including job title, name of supervisor, dates employment started/stopped

Q. Have you attended any educational institutions at a secondary level or above ?

Click Yes or No
If Yes you must give the Number of Educational Institutions Attended and add
name of the school, address, course of study, degree/diploma, dates attendance started/stopped

Additional Work/Education/Training Information
(For applicants 14 and over)

Q. Have you ever served in the military ?

If Yes – Name of Country/Region, Branch of Service, Rank/Position, Military Specialty, dates of service (from/to), specify location

Q. Have you belonged to, contributed to, or worked for any professional, social, or charitable organization ?

If Yes – Provide a List with Name(s) of Organization(s)

Q. Do you have any specialized skills or training, such as firearms, explosives, nuclear, biological our chemical experience ?

If Yes – Explain Skills/Training

Q. Have you ever served in, been a member of, or been involved with a paramilitary unit, vigilante unit, rebel group, or insurgent organization ?

If Yes – Provide Explanation

Q. Can you speak and/or read other languages than your native language ?

If Yes – List the Languages

Petitioner Information
DV Winners do not have a sponsor, therefore answer for Petitioner SELF
This also applies to family members possibly immigrating with you

Security and Background: Medical and Health Information

Q. Do you have a communicable disease of public health significance such as TB ?

Yes/No

Q. Do you have documentation to establish that you have received vaccinations in accordance with U.S. law ?

Yes/No
Click No and Explain: “Vaccinations must be proven at the beginning of the medical exam or will be given during this examination. I will comply with U.S. Immigration law also in this regard.”

Q. Do you have a mental or physical disorder that poses or is likely to pose a threat to the safety or welfare of yourself or others ?

Yes/No

Q. Are you or have you ever been a drug abuser or addict ?

Yes/No

Security and Background: Criminal Information

Q. Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty or similar action ?

Yes/No

Q. Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substances ?

Yes/No
Six more questions regarding criminal activities and possibly profiting from these activities (trafficking in controlled substances, money laundering, prostitution, human trafficking).

Security and Background: Security Information 1

Questions regarding espionage, sabotage, terrorism, genocide, torture, violence, killings, etc.)

Security and Background: Security Information 2

Questions regarding memberships or affiliations with groups and parties adversarial to the U.S. and its interests.

Security and Background: Immigration Law Violations Information 1
Q. Have you ever sought to obtain or assist others to obtain a visa, entry into the U.S., or any other U.S. immigration benefit by fraud or willful misrepresentation or other unlawful means ?

Yes/No
Six more question regarding unlawful presence in the U.S.

Security and Background: Immigration Law Violations Information 1

Q. Have you ever been

• unlawfully present and ordered removed from the U.S. during the last ten years ?
• convicted of an aggravated felony and been ordered removed from the U.S. ?
• unlawfully present in the U.S. for more then 180 days (but no more than one year) and have voluntarily departed the U.S. within the last three years ?
• unlawfully present in the U.S. for more than one year in the aggregate at any time during the last 10 years ?

Security and Background: Miscellaneous Information 1 and 2

Questions about possible criminal and other unwanted acts that you already committed in the U.S. or intend to commit.

If any of the Personal Information questions must be answered Yes consult an immigration lawyer
Social Security Number Information Page
Q. Have you ever applied for a Social Security Number ?

Yes/No
If Yes you will be asked if you were issued a number
If Yes you must give your SSN or select Do Not Know

Q. Do You need a New Card Issued ?

Yes/No
The next Q. asks if you authorize your information to be shared with the Soc. Sec. Adm. in order to assign you a SSN and issue you a Soc. Sec. Card.

Yes/No
If Yes the procedure for your SSN will be started when your visa is issued. You need this number to be able to work in the U.S.

Sign and Submit Page
Q. Preparer of Application Did anyone assist you in filling out this application ?

Yes or No
Click No unless you were assisted by an immigration lawyer

E-Signature

If you are a male and under 26 years old, or if any of the children coming with you is between 18 and 21, you must click on the link to Form DS-1810 Notice of Duty to Register with the Selective Service, before you sign. DS-1810 contains information about the Selective Service System. If you do not click the link to read this information the CEAC system will not accept your completed Form DS-260.

Enter your Case Number
Enter your Passport Number
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Click the button Sign and Submit Application

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