Formulaire ESTA en ligne pour voyager aux Etats-Unis Esta Formulaire

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1Complete

2Confirm

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Personal Information

Name*

Surname*

Are you known by other names or nicknames?*

Yes

No

Name 1*

Name 2*

Gender*

Female

Male

Date of birth*

Month*

Year*

City of birth*

Country of birt*

Mother's name*

Mother's surname*

Father's name*

Father's surname*

Passport Information

Passport number*

Passport issue country*

Passport issue date*

Month*

Year*

Passport expiry date*

Month*

Year*

Upload your passport

File

Drop files here or

Accepted file types: jpg, jpeg, gif, png, Max. file size: 256 MB, Max. files: 3.

Please, upload a picture of the personal information page of your passport. Make sure that the machine-readable text below the personal data is well visible and not under wrong angle.

OTHER CITIZENSHIP / NATIONALITY

I. Are you now a citizen of another country?*

Country*

How did you acquire another citizenship / nationality?*

Else*

II. Have you ever been issued a passport or a national identity card to travel to another country?*

Other citizenship / nationality*

Document type*

Document number*

Expiration year*

Country of issue*

Personal address

Home adress

Address 1*

Address 2

Number of apartments

Grad*

Province / Region*

State*

Phone type*

Prefix + phone number*

E-mail*

E-mail E-mail confirm

Contact information for emergencies in the U.S. or abroad

Name*

Surname*

Telephone number*

E-mail

Occupational data

Do you work now or have you worked in the past for a corporation / company?*

Yes

No

Hidden

You are not a farmer in the USA

Profession

Company name*

Address line*

City*

State*

Telephone number

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SOCIAL MEDIA (OPTIONAL)

Service Provider / Platform

Other gesture services / dishwashing*

Username*

Travel information

Are you traveling in transit to another country?*

Yes

No

Contact or hotel name

Address line*

House or apartment number*

City

State*

Telephone number*

Country*

Telephone number

MEMBERSHIP IN GE

Are you a member of the CBP Global Entry?*

No

Yes

Registration number / PASSID*

Answer Yes or No to the following questions

1) Do you have an infectious disease; physical or mental disorder; are you a drug addict or an addict?*

Yes

No

2) Have you ever been arrested or convicted of a criminal offense that resulted in serious damage to property or serious harm to another person or government body?*

Yes

No

3) Have you ever violated any law relating to the possession, use or distribution of illegal drugs?*

Yes

No

4) Are you trying to get involved or have you ever participated in terrorist activities, espionage, sabotage or genocide?*

Yes

No

5) Have you ever committed fraud or misrepresented yourself or others to obtain or help others obtain a visa or enter the United States?*

Yes

No

6) Are you currently looking for a job in the United States or where you were previously employed in the United States without prior permission from the U.S. government?*

Yes

No

7) Have you ever been denied a US visa or entry into the US or have your visa been revoked? If yes, explain when and where?*

Yes

No

Where*

When*

8) Have you ever stayed in the United States longer than the period of residence granted to you by the United States Government?*

Yes

No

9) Did you travel to or were present in Iraq, Syria, Iran, Sudan, Libya, Somalia or Yemen on or after 1 March 2011?*

Yes

No

I accept the Terms and Conditions*

Yes

I agree to receive emails regarding my application for ESTA and the call for renewal of my travel permit.*

Yes

By going to the next page, I confirm that I have read all the questions and the statement of this application form and that I have understood them. The information I have provided in the application form above is true and correct to the best of my knowledge and belief.

SUBMITTING YOUR APPLICATION FOR ESTA: Check the accuracy of all information before submitting the application. If an item is incorrect, click the Edit and Correct button. If the information is correct, continue to the payment page.

ALL INFORMATION
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Payment information

REQUEST FOR ESTA AND DOCUMENT

Price:

Choose a payment method*

CreditCard

CREDIT CARD*

American Express

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MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Credit card number

Expiration Date Month Year

CVV NAMES ON CREDIT CARD

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Personal Information

Passport Information

Upload your passport

OTHER CITIZENSHIP / NATIONALITY

Personal address

Home adress

Contact information for emergencies in the U.S. or abroad

Occupational data

You are not a farmer in the USA

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SOCIAL MEDIA (OPTIONAL)

Travel information

MEMBERSHIP IN GE

Answer Yes or No to the following questions

ALL INFORMATION