Crosswalk for new ESTA I94W Questions

Crosswalk of Data Elements I94W Current and Revised.docx

Arrival and Departure Record

Crosswalk for new ESTA I94W Questions

OMB: 1651-0111

Document [docx]
Download: docx | pdf

Information Collection

Form I-94W/ESTA

Current version

Form I-94/ESTA

Revised version

Family name, First name

Date of birth

Country of birth

Country of citizenship

Gender

Airline and Flight Number

Country where you live

Passport information



Passport number

Issuance date

Expiration date

City where you boarded

Telephone number





Email address





Signature

Date


Legend:


= mandatory

 = optional
























QUESTIONS



Form I-94W/ESTA

Current Version


Form I-94W/ESTA

Revised Version


Communicable disease, physical or mental disorder, drug abuser or addict?



Disease of public health significance: Chancroid, Gonorrhea, Granuloma inguinale, Infectious Leprosy, Infectious Syphilis, Lymphogranuloma venereum, Active Tuberculosis?





Arrested/convicted for offense/crime involving moral turpitude or violation related to controlled substance; arrested/convicted for two or more offenses for which aggregate sentence to confinement was five years or more; controlled substance trafficker, or seeking entry to engage in criminal/immoral activities?




Arrested, convicted of a crime for serious damage to property, serious harm to another person/government authority?


Have you ever violated any law related to possessing, using, or distributing illegal drugs?



Have you ever been or are you now involved in espionage or sabotage; or in terrorist activities; or genocide; or between 1933 and 1945 were involved, in any way, in persecution associated with Nazi Germany or its allies?


Do you seek to engage in or have you ever engaged in terrorist activities?


Are you seeking to work in the U.S.; or have you ever been excluded or deported; or been previously removed from the United States; or procured or attempted to procure a visa or entry into the U.S. by fraud or misrepresentation?



Are you currently seeking employment in the United States or you were previously employed

in the United States without prior permission from the U.S. government?


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?



Have you ever detained, retained or withheld custody of a child from a U.S. citizen granted

custody of the child?








Have you ever been denied a U.S. visa or entry into the U.S. or had a U.S. visa cancelled? If yes,

when? ________________________

where? ________________________










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? If yes,

When? ____________________

Where? ________________________




Have you ever asserted immunity from prosecution?







Have you ever overstayed a previous period of lawful admission to the United States, even by

one day?







File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorAJR
File Modified0000-00-00
File Created2021-01-27

© 2024 OMB.report | Privacy Policy