This form contains 116 fields organized into 24 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
A. CASE INFORMATION (To be completed by NVC)
NVC Case Number Text
Enter the National Visa Center (NVC) case number assigned to this applicant.
Assigned Post Text
Enter the U.S. embassy or consulate post assigned to process this case.
Post Point of Contact Information Text
Enter the assigned post’s point-of-contact (POC) details for this case (e.g., name, email, and/or phone number).
Applicant Name and Sex
Passport Name - Last (Surname) Text
Enter your last name (surname) exactly as it appears on your passport.
Passport Name - First (Given) Text
Enter your first name (given name) exactly as it appears on your passport.
Passport Name - Middle Text
Enter your middle name exactly as it appears on your passport (leave blank if none).
Sex Text
Enter your sex as shown on your passport.
Case Membership Basics
Case Size Text
Enter the total number of people included in your case (yourself plus any family members traveling with you).
Yes (Principal Applicant) Checkbox
Check this box if you are the principal applicant (PA) for the case.
No (Not Principal Applicant) Checkbox
Check this box if you are not the principal applicant (PA) for the case.
Relationship to Principal Applicant Text
If you are not the principal applicant, enter your relationship to the principal applicant (e.g., husband, wife, son, daughter). Fill only if 'No (Not Principal Applicant)' is 'Yes'.
Depends on: No (Not Principal Applicant)
Contact Information
Physical Address Text
Enter your current physical residential address (street address, city, state/province, and country).
Phone Number(s) Text
Enter your phone number(s) where you can be reached.
Email Address Text
Enter your email address.
E. COMMENTS
Comments Text
Enter any additional comments or explanations related to your application that are not captured elsewhere on the form. Fill only if 'Do you have family members or friends already residing in the United States?' is 'Yes' and the number exceeds 7.
Depends on: Yes
Fifth Family Member (Cross Reference Table)
Fifth Family Member Last Name Text
Enter the last (family) name of the fifth immediate family member being processed on a separate special immigrant visa case. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Fifth Family Member First Name Text
Enter the first (given) name of the fifth immediate family member being processed on a separate special immigrant visa case. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Fifth Family Member Middle Name Text
Enter the middle name of the fifth immediate family member being processed on a separate special immigrant visa case. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Relationship to You (Fifth Family Member) Date
Enter how the fifth family member is related to you (for example, spouse, son, daughter). Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Date of Birth Unknown (Family Member 5) Checkbox
Check this box if the fifth family member’s date of birth is unknown and you cannot provide a complete date (dd mmm yyyy). Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Special Immigrant Visa Case Number (Fifth Family Member) Text
Enter the special immigrant visa case number for the fifth family member. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
First Family Member (Cross Reference Table)
Family Member 1 Last Name Text
Enter the last (family) name of the first immediate family member who has their own special immigrant visa case. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family Member 1 First Name Text
Enter the first (given) name of the first immediate family member who has their own special immigrant visa case. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family Member 1 Middle Name Text
Enter the middle name of the first immediate family member who has their own special immigrant visa case. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family Member 1 Date of Birth Date
Enter the first immediate family member’s date of birth. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Date of Birth Unknown Checkbox
Check this box for the first listed family member if you do not know their date of birth. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family Member 1 SIV Case Number Text
Enter the special immigrant visa (SIV) case number for the first immediate family member. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
First U.S. Family/Friend Info (Row 1)
Last Name Text
Enter the last (family) name of your first U.S.-based family member or friend. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
First Name Text
Enter the first (given) name of your first U.S.-based family member or friend. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Middle Name Text
Enter the middle name of your first U.S.-based family member or friend, if any. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Sex Text
Enter the sex of your first U.S.-based family member or friend. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
U.S. Address Text
Enter the current U.S. address where your first U.S.-based family member or friend lives. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Phone Number Text
Enter the phone number for your first U.S.-based family member or friend. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Email Address Text
Enter the email address for your first U.S.-based family member or friend. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Fourth Family Member (Cross Reference Table)
Family Member 4 - Last Name Text
Enter the fourth family member’s last (family) name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family Member 4 - First Name Text
Enter the fourth family member’s first (given) name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family Member 4 - Middle Name Text
Enter the fourth family member’s middle name (if any). Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family Member 4 - Date of Birth Date
Provide the fourth family member’s date of birth. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family Member 4 - Date of Birth Unknown Checkbox
Check this box for the fourth listed family member if their date of birth is unknown. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family Member 4 - Special Immigrant Visa Case Number Text
Enter the special immigrant visa case number for the fourth family member. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Fourth U.S. Family/Friend Info (Row 4)
Family/Friend Last Name (Row 4) Text
Enter the last (family) name of the fourth family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend First Name (Row 4) Text
Enter the first (given) name of the fourth family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend Middle Name (Row 4) Text
Enter the middle name of the fourth family member or friend residing in the United States, if any. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend Sex (Row 4) Text
Enter the sex of the fourth family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend Address (Row 4) Text
Enter the current U.S. address of the fourth family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend Phone Number (Row 4) Text
Enter the phone number of the fourth family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend Email Address (Row 4) Text
Enter the email address of the fourth family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
General
VFPage2AdditionalCalc Text
Relationship to You (Family Member 1) Combobox
Enter the relationship between you and the first listed family member (e.g., spouse, child, parent). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Relationship to You (Family Member 2) Combobox
Enter the relationship between you and the second listed family member (e.g., spouse, child, parent). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Relationship to You (Family Member 3) Combobox
Enter the relationship between you and the third listed family member (e.g., spouse, child, parent). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Relationship to You (Family Member 4) Combobox
Enter the relationship between you and the fourth listed family member (e.g., spouse, child, parent). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Relationship to You (Family Member 5) Combobox
Enter the relationship between you and the fifth listed family member (e.g., spouse, child, parent). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Relationship to You (Family Member 6) Combobox
Enter the relationship between you and the sixth listed family member (e.g., spouse, child, parent). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Relationship to You (Family Member 7) Combobox
Enter the relationship between you and the seventh listed family member (e.g., spouse, child, parent). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Relationship to You (Person 1) Combobox
Enter how the first listed family member or friend residing in the United States is related to you (e.g., spouse, parent, sibling, friend). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Relationship to You (Person 2) Combobox
Enter how the second listed family member or friend residing in the United States is related to you (e.g., spouse, parent, sibling, friend). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Relationship to You (Person 3) Combobox
Enter how the third listed family member or friend residing in the United States is related to you (e.g., spouse, parent, sibling, friend). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Relationship to You (Person 4) Combobox
Enter how the fourth listed family member or friend residing in the United States is related to you (e.g., spouse, parent, sibling, friend). Fill only if 'Yes' is 'Yes'.
US GN SB HB FC WB BH GH HU SS GF SO SL FN NE GG DI SN DA MO SD GD GR MC GM AU FA HS SM FR WI GS WS NI BR MI SF SI FI UN
Language Skills
Native Language and Proficiency Text
Enter your native language and indicate your reading, writing, and speaking ability in that language.
Other Languages and Proficiency Text
List any other languages you speak and indicate your reading, writing, and speaking ability for each.
English Speaking Ability Text
State your English speaking ability (e.g., Good, Some, or None).
Medical and Pregnancy Information
Estimated Delivery Date (EDD) Date
Enter the estimated delivery date if the applicant is pregnant.
Health Issues Explanation Text
Describe any current or significant health issues the applicant has, including relevant details.
Occupation and Education
Occupation or Skill Text
Enter your current occupation and/or primary professional skill (e.g., job title or trade).
Education Level and Field of Study Text
Enter your highest education level completed and your field of study or major.
Other Immediate Family Members Being Processed (Cross Reference)
Yes Checkbox
Check this box if you have other immediate family members being processed on their own special immigrant visas.
No Checkbox
Check this box if you do not have any other immediate family members being processed on their own special immigrant visas.
Other Immediate Family Members Being Processed Details Text
List any other immediate family members being processed on their own special immigrant visas, including each person’s full name, relationship to you, and their special immigrant visa case number. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Personal Details (Marital Status, Birth, Nationality, Ethnicity, Religion)
Marital Status Text
Enter your current marital status (e.g., single, married, divorced, widowed).
Date of Birth Date
Enter your date of birth.
Place of Birth Text
Enter your place of birth including city and country.
Nationality Text
Enter your nationality (citizenship).
Ethnicity Text
Enter your ethnicity.
Religion Text
Enter your religion.
Pregnancy & Estimated Delivery Date
Currently Pregnant Combobox
Indicate whether the applicant is currently pregnant (e.g., Yes or No).
No Yes
Question 22 - Family/Friends Residing in the U.S. (Yes/No)
Yes Checkbox
Check this box if you have any family members or friends already residing in the United States.
No Checkbox
Check this box if you do not have any family members or friends already residing in the United States.
Second Family Member (Cross Reference Table)
Second family member last name Text
Enter the second family member’s last (family) name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second family member first name Text
Enter the second family member’s first (given) name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second family member middle name Text
Enter the second family member’s middle name (or leave blank if none). Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second family member date of birth Date
Enter the second family member’s date of birth. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Date of Birth Unknown (Family Member 2) Checkbox
Check this box if the second listed family member’s date of birth is unknown. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second family member special immigrant visa case number Text
Enter the special immigrant visa case number for the second family member. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second U.S. Family/Friend Info (Row 2)
U.S. Family/Friend 2 Last Name Text
Enter the last name (surname) of the second family member or friend living in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
U.S. Family/Friend 2 First Name Text
Enter the first (given) name of the second family member or friend living in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
U.S. Family/Friend 2 Middle Name Text
Enter the middle name of the second family member or friend living in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
U.S. Family/Friend 2 Sex Text
Enter the sex of the second family member or friend living in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
U.S. Family/Friend 2 Address Text
Enter the U.S. address where the second family member or friend currently lives. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
U.S. Family/Friend 2 Phone Number Text
Enter the phone number for the second family member or friend living in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
U.S. Family/Friend 2 Email Address Text
Enter the email address for the second family member or friend living in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Seventh Family Member (Cross Reference Table)
Seventh Family Member Last Name Text
Enter the seventh family member's last (family) name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Seventh Family Member First Name Text
Enter the seventh family member's first (given) name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Seventh Family Member Middle Name Text
Enter the seventh family member's middle name, if any. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Seventh Family Member Date of Birth Date
Enter the seventh family member's date of birth. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Date of Birth Unknown (Family Member 7) Checkbox
Check this box if the date of birth for the seventh listed family member is unknown. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Seventh Family Member Special Immigrant Visa Case Number Text
Enter the special immigrant visa case number for the seventh family member. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Sixth Family Member (Cross Reference Table)
Sixth Family Member Last Name Text
Enter the sixth family member’s last (family) name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Sixth Family Member First Name Text
Enter the sixth family member’s first (given) name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Sixth Family Member Middle Name Text
Enter the sixth family member’s middle name (if any). Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Sixth Family Member Relationship to You Date
Enter how this sixth family member is related to you (e.g., spouse, child, parent, sibling). Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Date of Birth Unknown (Family Member 6) Checkbox
Check this box if the 6th family member’s date of birth is unknown and you cannot provide it in the Date of Birth field. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Sixth Family Member SIV Case Number Text
Enter the special immigrant visa (SIV) case number for the sixth family member. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Third Family Member (Cross Reference Table)
Third Family Member Last Name Text
Enter the third family member’s last (family) name as it appears on their records. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Third Family Member First Name Text
Enter the third family member’s first (given) name as it appears on their records. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Third Family Member Middle Name Text
Enter the third family member’s middle name (or middle initial, if applicable). Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Third Family Member Date of Birth Date
Enter the third family member’s date of birth. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Date of Birth Unknown (Family Member 3) Checkbox
Check this box if the third listed family member’s date of birth is unknown. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Third Family Member SIV Case Number Text
Enter the third family member’s Special Immigrant Visa (SIV) case number. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Third U.S. Family/Friend Info (Row 3)
Family/Friend 3 Last Name Text
Enter the last name (surname) of the third family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend 3 First Name Text
Enter the first name (given name) of the third family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend 3 Middle Name Text
Enter the middle name of the third family member or friend residing in the United States, if any. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend 3 Sex Text
Enter the sex of the third family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend 3 Address Text
Enter the current U.S. address of the third family member or friend. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend 3 Phone Number Text
Enter the phone number of the third family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family/Friend 3 Email Address Text
Enter the email address of the third family member or friend residing in the United States. Fill only if 'Yes' is 'Yes'.
Depends on: Yes