esta
USA-Wappen
ENTER APPLICANT INFORMATION ( Please provide all responses in English )
*Family Name
*First (Given) Name
*Are you known by any other names or aliases? Yes No
*City of Birth
*Country of Birth
*Date of Birth
*Gender
Male
Female
PARENTS
*Lastname father
*Firstname father
*Lastname mother
*Firstname mother
CONTACT INFORMATION
*Country
*Address:
*House/Apartment Number:
*Zip Code:
*City:
*State/Province/Region:
*E-mail Address
Phone
*Country Code
*Phone Number
Passport Information
*Passport Number
*Issuing Country
*Issuance Date
*Expiration Date
*Country of Citizenship
*National Identification Number
    (Personal Identification Number)
*Have you ever been issued a passport or national identity card for travel by any other country? Yes No
* Are you now, a citizen or national of any other country? Yes No
* Have you ever been a citizen or national of any other country? Yes No
* Are you a member of the CBP Global Entry Program? Yes No
EMERGENCY CONTACT INFORMATION IN OR OUT OF THE U.S.
EMERGENCY CONTACT INFORMATION
*Family Name
*First (Given) Name
Phone Number
*Country Code
*Phone Number
*E-mail Address
ENTER TRAVEL INFORMATION ( Please provide all responses in English. )
* Is your travel to the US occurring in transit to another country? Yes No
EMPLOYMENT INFORMATION
*Do you have a current or previous employer? Yes 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.

Yes 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? Yes No
*3) Have you ever violated any law related to possessing, using, or distributing illegal drugs? Yes No
*4) Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide? Yes 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? Yes 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? Yes 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? Yes 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? Yes No
*9) Have you traveled to, or been present in Iraq, Syria, Iran, Sudan, Libya, Somalia or Yemen on or after March 1, 2011? Yes No
WAIVER OF RIGHTS:
I have read and understand that I hereby waive for the duration of my travel authorization obtained via ESTA any rights to review or appeal of a U.S. Customs and Border Protection Officer's determination as to my admissibility, or to contest, other than on the basis of an application for asylum, any removal action arising from an application for admission under the Visa Waiver Program.

In addition to the above waiver, as a condition of each admission into the United States under the Visa Waiver Program, I agree that the submission of biometric identifiers (including fingerprints and photographs) during processing upon arrival in the United States shall reaffirm my waiver of any rights to review or appeal of a U.S. Customs and Border Protection Officer's determination as to my admissibility, or to contest, other than on the basis of an application for asylum, any removal action arising from an application for admission under the Visa Waiver Program.

In addition to the above disclaimer, I agree that the submission of biometric identifiers (such as fingerprints and photographs) during customs and border processing upon arrival in the United States, which is a condition with respect to each entry into the United States under the program Visa Waiver Program, my waiver of all rights to appeal or appeal against United States Customs and Border Protection by the United States Customs and Border Protection Authority, and except as provided in the context an application for asylum, the contestation of any deportation action resulting from an application for visa waiver program entry.


*CERTIFICATION: I, the applicant, hereby certify that I have read, or have had read to me, all the questions and statements on this application and understand all the questions and statements on this application and I confirm that I agree to the terms and conditions of this website. The answers and information furnished in this application are true and correct to the best of my knowledge and belief.

THIRD PARTIES ONLY: For third-parties submitting the application on behalf of the applicant, I hereby certify that I have read to the individual whose name appears on this application (applicant) all the questions and statements on this application. I further certify that the applicant certifies that he or she has read, or has had read to him or her, all the questions and statements on this application, understands all the questions and statements on this application, and waives any rights to review or appeal of a U.S. Customs and Border Protection Officer's determination as to his or her admissibility, or to contest, other than on the basis of an application for asylum, any removal action arising from an application for admission under the Visa Waiver Program. The answers and information furnished in this application are true and correct to the best of the applicant's knowledge and belief.
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www.esta-pro.org is a non-government service provider to apply for ESTA authorization.

Here you can receive the ESTA entry permit and make use of our services. Every application is checked and processed by our support team. This will enable you to enter the USA without any difficulties, e.g. formal errors.

If you apply for your ESTA via us, the authorisation will be valid for two years from the date of issue, or until your passport expires, whichever comes first.

If you lose the ESTA registration number you can retrieve it free of charge for a period of two years. You can also use further services. This service costs 65 EURO and includes the 14 USD fee for the United States Border Control.

You can also fill out your application at your own risk on the website of the US Department of Homeland Security https://esta.cbp.dhs.gov However, please note that in the case you will not have the real-time support of a member of our support team and there is a risk that you could make incorrect submissions.