Electronic Diversity Visa Entry Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DS-5501 Electronic Diversity Visa Entry Lottery Form	Form and Instruction	New	Available
Form DS-5501 Electronic Diversity Visa Entry Lottery Form	Form and Instruction	Unchanged	Available
(005) Tab 4B - Legal Authorities, DS-5501 - DV Passport Final Rule - 2025 [DHS-OMB package].docx	Supplementary Document	Uploaded 2026-03-12	Available
(004) Tab 3 -- Legal Authorities 30 Day -- 30 Day DS-5501.docx	Supplementary Document	Uploaded 2022-05-23	Available
Justification for non-substantive change.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2017-07-25	Available
DS-5501 Legal Authorities.doc	Supplementary Document	Uploaded 2016-08-03	Source copy available
(005) Tab 4A - PRA Supporting Statement, DS-5501 - DV Passport Final Rule - 2025 [DHS-OMB package].docx	Supporting Statement A	Uploaded 2026-03-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
279464	Electronic Diversity Visa Entry Form	Form and Instruction	New	Electronic Diversity Visa Entry Lottery Form
279464	Electronic Diversity Visa Entry Form	Form and Instruction	New
15041	Electronic Diversity Visa Entry Form	Form and Instruction	Unchanged	Electronic Diversity Visa Entry Lottery Form
15041	Electronic Diversity Visa Entry Form	Form and Instruction	Unchanged

ICR Details

OMB Control No: 1405-0153	ICR Reference No: 202603-1405-002
Status: Historical Inactive	Previous ICR Reference No: 202205-1405-001
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Electronic Diversity Visa Entry Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 03/12/2026
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 03/16/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/12/2026
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2025	6 Months From Approved	04/30/2026
Responses	11,072,400	0	11,072,400
Time Burden (Hours)	5,536,200	0	5,536,200
Cost Burden (Dollars)	55,362,000	0	55,362,000

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Abstract: The Department of State utilizes the Electronic Diversity Visa Lottery (EDV) Entry Form to elicit information necessary to ascertain the applicability of the legal provisions of the diversity immigrant visa program. The foreign nationals complete the electronic entry forms and then applications are randomly selected for further participation in the program.

Emergency Justfication: The DS-5501 information collection is necessary because the Department requires certain information to verify eligibility of aliens who enter the Diversity Visa program. Immigration and Nationality Act (“INA”) Section 203(c) [8 U.S.C. § 1153(c)], provides for a class of immigrants known as “diversity immigrants” from countries with historically low rates of immigration to the United States. Pursuant to INA section 204(a)(1)(I) [8 U.S.C. § 1154(a)(1)(I)], all aliens seeking diversity immigrant status must submit a petition (the DS-5501) but may apply for a diversity visa only if randomly selected in the diversity visa lottery and only during the specific fiscal year for which they were selected. The Secretary of State is authorized to establish, through regulations, the information that must be included in the petition and any documentary evidence required to support the petition. Accordingly, 22 CFR § 42.33(b) outlines the specific information that must be included in the petition as well as documentation required to support the petition.

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Authorizing Statute(s): US Code: 8 USC 1201 Name of Law: Immigration and Nationality Act
   US Code: 8 USC 1153 Name of Law: Immigration and Nationality Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1400-AF76	Final or interim final rulemaking	91 FR 11891	03/11/2026

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Electronic Diversity Visa Entry Form	DS-5501	Electronic Diversity Visa Entry Lottery Form
Electronic Diversity Visa Entry Form	DS-5501	Electronic Diversity Visa Entry Lottery Form

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Department estimates the amount of time respondents will take to complete the DS-5501 is 90 minutes per response. If we multiply this by 10 million (the annual estimate for submissions), we calculate a total hour time burden of 15,000,000 hours.

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Annual Cost to Federal Government: $3,478,946

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/12/2026

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