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ELECTRONIC DIVERSITY VISA ENTRY FORM OMB Control Number: 1405-0153
Form: DS-5501
Expires: 05/31/2010
Estimated Burden: 30 minutes

Submission Confirmation: Entry Received

Success!

                                                                                                                        Printer friendly version

Your entry for the 2011 Diversity Visa Lottery Program Lottery Entry Form was received on Saturday, November 21, 2009 at 7:29:19 PM EST. Please do not close this window until you have printed this confirmation page or made a record of your Confirmation Number.

Entrant Name: Kantsara, Valeriy Dmitrievich
Confirmation Number: 20111R7SQHONBBM1
Year of Birth: 1959

Thank you for your entry for the 2011 Diversity Visa Lottery.

Please either print this page or make a record of the confirmation number before closing this window. You will not be able to retrieve this number after you close this window.

You must retain your confirmation number in order to check your entry status using the internet. You may check back at this link http://www.dvlottery.state.gov/ESC/ between July 1, 2010 and June 30, 2011 to determine whether your entry was selected for further processing in the 2011 DV Lottery. You will be required to enter your confirmation number in combination with other personal information in order to check on your entry status.

Selectees will also receive a letter through their country's postal service notifying them of their selection. Entrants who are not selected for further processing will not receive any type of notification through mail.

Do not submit additional Entry Forms with this person as the Primary Entrant! Multiple entries will disqualify the entrant from participation in the Lottery.