Authorization Approved
Official Website of the Department of Homeland SecurityCLOSEYour 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):
- Cholera
- Diphtheria
- Tuberculosis, infectious
- Plague
- Smallpox
- Yellow Fever
- Viral Hemorrhagic Fevers, including Ebola, Lassa, Marburg, Crimean-Congo
- Severe acute respiratory illnesses capable of transmission to other persons and likely to cause mortality.
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
Regards,
Clark Chien
Account Management
✆: +886-2-6612-2821 | Mobile: +886-927-611-419 (Speed dial: 8010-2821)
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