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Authorization Approved
Official Website of the Department of Homeland Security
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Your travel authorization has been approved and you are authorized to travel to the United States under the Visa Waiver Program. This does not guarantee admission to the United States; a Customs and Border Protection (CBP) officer at a port of entry will have the final determination.
| Application Number | Expiration Date |
|---|---|
| R793R979XRQK27CK | Oct 4, 2021 |
Payment Receipt
| Payment Date | October 4, 2019 |
| Payment Tracking Code | 26KKRBCS |
| Payment Received | $14.00 |
|---|
Applicant Information
| Family Name | First (Given) Name |
|---|---|
| CHIEN | YI SEN |
| Are you known by any other names or aliases? | No |
| Date of Birth | Gender |
|---|---|
| Sep 15, 2008 | M (Male) |
| City of Birth | Country of Birth |
| TAIPEI CITY | TAIWAN (TWN) |
PARENTS
| Family Name | First (Given) Name |
|---|---|
| CHIEN | CHENG-TAI |
| Family Name | First (Given) Name |
|---|---|
| LIN | HSING-HUA |
Passport Information
| Passport Number | Issuing Country |
|---|---|
| 314413880 | TAIWAN (TWN) |
| Issuance Date | Expiration Date |
| Feb 2, 2017 | Feb 2, 2022 |
| Issuing Country | National Identification Number |
| TAIWAN (TWN) | A132245221 |
| Personal Identification Number | A132245221 |
| Have you ever been issued a passport or national identity card for travel by any other country? | No |
Other Citizenship/Nationality
| Are you now, a citizen or national of any other country? | No |
|---|---|
| Have you ever been a citizen or national of any other country? | No |
GE MEMBERSHIP
| Are you a member of the CBP Global Entry Program? | No |
|---|
YOUR CONTACT INFORMATION
| E-mail Address | |
|---|---|
| ethanyyii@gmail.com | |
| Telephone Number | |
| Telephone Type | Country Code + Phone / Number |
| Mobile | TAIWAN (TWN) (+886) / 906877915 |
| Home Address | |
| Address Line 1 | Apartment Number |
| NO. 18, LN. 256, XIANGNAN RD | |
| Address Line 2 | City |
| DONGSHAN TOWNSHIP | |
| State/Province/Region | Country |
| YILAN COUNTY | TAIWAN (TWN) |
Social Media (Optional)
Emergency Contact
| Emergency Contact | |
|---|---|
| Family Name | First (Given) Name |
| CHIEN | CHENG-TAI |
| Telephone Number | |
| Country Code + Phone | Number |
| TAIWAN (TWN) (+886) | 927611419 |
| E-mail Address | |
| iphoneuse@gmail.com |
Travel Information
| Is your travel to the US occurring in transit to another country? | No |
|---|---|
| Address While in the U.S. | |
| Address Line 1 | Apartment Number |
| Address Line 2 | City |
| State | |
| U.S. Point of Contact Information | |
| HYATT PLACE LOS ANGELES/LAX/EL SEGUNDO | |
| Address | |
| Address Line 1 | Apartment Number |
| 750 N NASH ST | |
| Address Line 2 | City |
| EL SEGUNDO | |
| State | |
| CALIFORNIA | |
| Telephone Number | |
| Country Code + Phone | Number |
| UNITED STATES (USA) (+1) | 3103222880 |
EMPLOYMENT INFORMATION
| Do you have a current or previous employer? | No |
|---|
ELIGIBILITY QUESTIONS
1) Do you have a physical or mental disorder; or are you a drug abuser or addict; or do you currently have any of the following diseases (communicable diseases are specified pursuant to section 361(b) of the Public Health Service Act):
| No |
|---|---|
| 2) Have you ever been arrested or convicted for a crime that resulted in serious damage to property, or serious harm to another person or government authority? | No |
| 3) Have you ever violated any law related to possessing, using, or distributing illegal drugs? | No |
| 4) Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide? | No |
| 5) Have you ever committed fraud or misrepresented yourself or others to obtain, or assist others to obtain, a visa or entry into the United States? | No |
| 6) Are you currently seeking employment in the United States or were you previously employed in the United States without prior permission from the U.S. government? | No |
| 7) Have you ever been denied a U.S. visa you applied for with your current or previous passport, or have you ever been refused admission to the United States or withdrawn your application for admission at a U.S. port of entry? | No |
| If yes: | |
|---|---|
| when | |
| where |
| 8) Have you ever stayed in the United States longer than the admission period granted to you by the U.S. government? | No |
|---|---|
| 9) Have you traveled to, or been present in Iran, Iraq, Libya, North Korea, Somalia, Sudan, Syria or Yemen on or after March 1, 2011? | No |
