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Last active October 12, 2021 11:16
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template.md

1. Name

Last Name = Sidorov First Name = Mitrofan Middle Name - check "No middle name"

2. Gender

Male

3. Birth Date

Month = 04 Day = 28 Year = 1956

4. City Where You Were Born

Birth City = Petushki

5. Country Where You Were Born

Country = Russia

6. Country of Eligibility for the DV Program

Are you claiming eligibility based on the country where you were born = No If not select the country = Ukraine

7. Passport

Last Name = Sidorov First Name = Mitrofan Middle Name = check "No middle name" Passport Number = 6789512309 (СЕРИЯ НЕ НУЖНА)

Passport Expiration Date Month = 07 Day = 05 Year = 2022

8. Photo

9. Mailing Address

a. in Care of = Marina Sidorov b. Address Line 1 = ul. Lenina 4, dom 2 c. Address Line 2 = d. City/Town = Petrovka e. District/County... = Rechnoy rayon, Tulskaya oblast f. Postal Code/Zip = E116 g. Country = Russia

10. Country Where You Live Today

Country = New Zealand

11. Phone Number

Number = +7-096-321-1234

12. E-mail Address

Email = mitrofan@sidorov.nz

13. What is the highest level of education you have achieved, AS OF TODAY?

Education = High School, no degree

14. What is your current marital status?

= Married and my spouse is not a US citizen...

15. Number of children

Children = 0

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