23/03/2023, 17:36 Immigrant Visa - Review Personal, Address, and Phone

Online Immigrant Visa and Alien Registration Application (DS-260)

Personal, Address, and Phone Information

Note: You have completed data entry for your 'Immigrant Visa and Alien Registration' application. Before submitting the
application, please review your entries below. To navigate to the next section to be reviewed, click the ‘Next’ button on the
bottom of the page. If an entry is incorrect, click on the links on the right side of the page, which will direct you to the page
where you entered the data. Once you have reviewed all sections, you will be directed to the Sign and Submit page to
complete the application process.

Name Provided: BERNARDES DE OLIVEIRA , ADILSON

Full Name in Native Language: ADILSON BERNARDES DE OLIVEIRA

Other Names Used: NO

Sex: MALE

Current Marital Status: MARRIED

Date of Birth: 09 OCTOBER 1969

City of Birth: SAO BERNARDO DO CAMP

State/Province of Birth: SAO PAULO

Country/Region of Birth: BRAZIL

Country/Region of Origin (Nationality): BRAZIL

Document Type: PASSPORT

Document ID: GA758318

Country/Authority that Issued Document: BRAZIL

Issuance Date: 05 NOVEMBER 2019

Expiration Date: 04 NOVEMBER 2029

Do you hold or have you held any nationality other than the NO
one you have indicated above?

Present Address: RUA IBATE, 36, JACATUBA

City: SANTO ANDRE

State/Province: SAO PAULO

Postal Zone/ZIP Code: 09290430

Country/Region: BRAZIL

From Date: DECEMBER 1999

Have you lived anywhere other than this address since YES
the age of sixteen?

Previous Address (1): RUA CAMILO CASTELO BRANCO, 309,

SACADURA CABRAL

City SANTO ANDRE

State/Province: SAO PAULO

Postal Zone/ZIP Code: 09060770

Country/Region: BRAZIL

From: OCTOBER 1969

To: DECEMBER 1999

Primary Phone Number: 5511987708944

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23/03/2023, 17:36 Immigrant Visa - Review Personal, Address, and Phone

Secondary Phone Number: 5511982771143

Work Phone Number: DOES NOT APPLY

Other Telephone Numbers Used: NO

Email Address: adilsonoliveira.77@gmail.com

Other Email Addresses Used: NO

Social Media Provider/Platform: FACEBOOK

Social Media User ID: ADILSON.OLIVEIRA.3572846?MIBEXTID=ZBWKWL

Other Social Media Used: NO

Is your Mailing Address the same as your Present Address? YES

Permanent Address

Name of person currently living at address: DOES NOT APPLY

U.S. Address: 6349 MIRAMONTE DR UNIT 106

ORLANDO, FLORIDA 32835

Phone Number: DOES NOT APPLY

Is this address where you want your Permanent Residence YES

Card (Green Card) mailed?

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