Part 1:
Security and Background: Immigration Law Violation
Information 1 Page
85
86
Security and Background: Immigration Law Violation
Information 2 Page
Displayed for all applicants who answered ‘Yes’ to ‘Have you ever been to the U.S.?’ on the Previous U.S.
Travel page. Answers to questions are ‘No’.
Security and Background: Immigration Law Violation
Displayed for all applicants who answered ‘Yes’ to ‘Have you ever been to the U.S.?’ on the Previous U.S.
Travel page. Answers to questions are ‘Yes’.
87
88
Security and Background: Miscellaneous Information 1
Page
Displayed for all applicants. A
nswers to questions are ‘No’.
89
Security and Background: Miscellaneous Information 1
Page
Displayed
for all applicants. Answers to questions are ‘Yes’.
90
Security and Background: Miscellaneous Information 2
Page
Displayed for all applicants. Answers to questions are ‘No’.
91
92
Security and Background: Miscellaneous Information 2
Page
Displayed
for all applicants. Answers to questions are ‘Yes’.
93
Social Security Number Information Page
94
Displayed for all applicants. Answers to questions are ‘No’.
Social Security Number Information Page
95
Displayed for all applicants. Answers to questions are ‘Yes’.
Social Security Number Information Page
96
Displayed for all applicants. Answers to the first three ques
tions are ‘Yes’ with the last question answered ‘No’.
97
Sign and Submit Page
Displayed for all applicants. Answered ‘No’ to the question ‘Did anyone assist you in filling out this application?’.
98
Sign and Submit Page
Displayed for all applican
ts. Answered ‘Yes’ to the question ‘Did anyone assist you in filling out this
application?’.
99
100
Sign and Submit Page
Displayed for all applicants. Answered ‘No’ to the question ‘Did anyone assist you in filling out this application?’.
If you are from B
enin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d’Ivoire, Democratic
Republic of the Congo, Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Ghana, Guinea, Guinea-Bissau, Iraq, Kenya,
Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo, Uganda,
Yemen then you will have an extra box on your Sign and Submit page. Applicants must certify they reviewed the
FGM/C government fact sheet, given they are from a FGM/C prevalent country/region.
101
102
Sign and Submit Page
Displayed for all applicants. Answered ‘Yes’ to the question ‘Did anyone assist you in filling out this application?’.
If you are from Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d’Ivoire, Democratic
Republic of the Congo, Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Ghana, Guinea, Guinea-Bissau, Iraq, Kenya,
Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo, Uganda,
Yemen then you will have an extra box on your Sign and Submit page. Applicants must certify they reviewed the
FGM/C government fact sheet, given they are from a FGM/C prevalent country/region.
103
104
Confirmation Page
Displayed for applicants when the case is at NVC.
105
Confirmation Page
106
Displayed for applicants when the case is at Post Displayed for DV applicants when
the case is at KCC
Confirmation Page
107
Confirmation Page
108
Displayed for DV applicants when the case is at Post
109
Copyright Page
– Immigrant Visa and Alien
Registration Application
110
Disclaimer Page
– Immigrant Visa and Alien
Registration Application
111
Paperwork Reduction Act Page
– Immigrant Visa
and Alien Registration Application
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