2. DATE AND PLACE OF BIRTH:

3. THE APPLICANT’S NATIVE COUNTRY IF DIFFERENT FROM COUNTRY OF BIRTH:

4. NAME, DATE AND PLACE OF BIRTH OF THE APPLICANT’S SPOUSE AND ALL NATURAL CHILDREN, AS WELL AS ALL LEGALLY-ADOPTED AND STEPCHILDREN, WHO ARE UNMARRIED AND UNDER THE AGE OF 21 YEARS, EVEN IF YOU ARE NO LONGER LEGALLY MARRIED TO THE CHILD’S PARENT, AND EVEN IF THE CHILD DOES NOT CURRENTLY RESIDE WITH YOU AND/OR WILL NOT IMMIGRATE WITH YOU:

5. FULL MAILING ADDRESS:

6. PHOTOGRAPH(S):