Form – USA ESTA VISA

ESTA APPLICATION USA

Apply for an Electronic System for Travel Authorization (ESTA)

Tourism | Study | Business | Transit

1General information

2Personal data

3Travel information

4Documents

5Eligibility

Basic information
Check your passport and fill out all data in the same format.

First name*

Fill in your name and surname exactly as stated in your passport. Avoid using diacritical marks.

Last name*

Fill in your name and surname exactly as stated in your passport. Avoid using diacritical marks.

Sex*

Select your sex as stated in your passport.

Man

Woman

Date of Birth*

Select your date of birth.

Day

Month

Year

City of Birth*

Fill in the city where you were born.

Country of Birth*

Choose your country of birth.

Email*

Enter a valid e-mail address. This will be used to send essential documents.

Email Confirm your email

I agree to receive emails regarding my ESTA application.

Phone number

Phone code*

Select a phone number code

Phone number*

Enter your phone number. In case of unexpected events, we will contact you this way.

Uloženo

Portrait Photo
To complete your ESTA application, you must upload a recent portrait photo that meets US government requirements. This photo will be used as part of your identity verification, so it must meet the following conditions:

• The photo must clearly show your full face, directly facing the camera.
• Do not wear sunglasses or hats. Prescription glasses are allowed only if they do not obscure your eyes.
• Your expression must be neutral (no smiling or frowning).
• The background should be plain and light-colored (white, grey, or cream).
• The photo must not be blurred or overexposed.
• The image must be well-lit and not contain shadows across your face.

Portrait Photo Sample

Would you like to upload your portrait photo now?*

Yes

File*

Drop files here or

Max. file size: 8 MB, Max. files: 1.

!!! A portrait photo (scan) is required to obtain a U.S. travel authorization. If you are currently unable to upload the portrait photo, you can send it later to info@usaestavisa.com !!!

Personal data
Provide all personal information truthfully.

Are you known by any other names or aliases?*

Specify, whether you are officially registered under other names or nicknames.

Yes

Enter your full name or a nickname*

Address of residence

Address*

Enter the address of your permanent residence (street and zip code), city, state and country. If your address does not have a street, write the name of your village and the zip code.

City*

Enter the address of your permanent residence (street and zip code), city, state and country. If your address does not have a street, write the name of your village and the zip code.

State/Province/Region*

Enter State/Province/Region

Country*

Enter the address of your permanent residence (street and zip code), city, state and country. If your address does not have a street, write the name of your village and the zip code.

Names of the parents

Father’s name*

Enter your father’s first name. If you don’t know, write “unknown”.

Father’s last name*

Enter your father’s last name. If you don’t know, write “unknown”.

Mother’s name*

Enter your mother’s first name. If you don’t know, write “unknown”.

Mother’s last name*

Enter your mother’s last name. If you don’t know, write “unknown”.

Employment information

Do you have or did you have an employer?*

Specify whether you have a current or previous employer. This answer is required for entry into the USA. This answer is required to complete your ESTA application.

Yes

Employer Name*

Write the name of your company or your current or last employer. If you are a business owner, write “Business owner”.

Employer’s address*

Enter the employer’s address and city. If you do not know, write “unknown”.

City*

Enter the employer’s address and city. If you do not know, write “unknown”.

State/Province/Region*

Enter the State/Province/Region and Country of the employer. If you do not know, write “unknown”.

Country*

Enter the State/Province/Region and Country of the employer. If you do not know, write “unknown”.

Travel information
Provide truthful travel information.

Is your travel to the US occurring in transit to another country?*

If you are traveling to the United States solely for the purpose of airport transfer and subsequent flight outside the United States, select the Yes check box. If the USA is your destination, check “No”.

Yes

Do you know the contact details of your accommodation?*

Yes

Contact details in the USA

Contact name*

Fill out the name of the person you are traveling to or the name of the accommodation. If you do not know the name of the person or the name of the accommodation, type “Unknown”.

Address*

Enter the address of your stay (street and identification number). If you don’t know the address, write “Unknown”.

City*

Fill in the city and state where you will stay. If you do not know your place of accommodation, write “Unknown”.

State*

Fill in the city and state where you will stay. If you do not know your place of accommodation, write “Unknown”.

Phone number*

Select a phone number code

Phone number*

Enter the telephone number of the person you are travelling to or the telephone number of the hotel. If you do not know the telephone number, write “0000”.

Emergency contact details

First name*

Fill in the first and last name of the person to be contacted in case of emergency. If you don’t have such a person, write ” Unknown “

Last name*

Fill in the first and last name of the person to be contacted in case of emergency. If you don’t have such a person, write ” Unknown “

Email*

Fill in the e-mail address of your emergency contact. If you do not know the address, enter “Unknown”.

Phone code*

Select a phone number code

Phone number*

Fill in a telephone contact for the emergency person. If you do not know the telephone contact, type “Unknown”.

Passport
To proceed with your ESTA application, you must upload your passport as required by the US government. You must upload a copy of your passport to successfully complete your application. Select the “Upload Passport” button to access your device’s camera. If you do not have a camera or scanner, you can upload a passport photo from your gallery. If you are completing the application on your computer, select the passport photo on your computer. You will find a sample passport photo next to or below the application form. Make sure that you take a photo of the entire biographical page of the passport. That means the whole page of your passport has to be visible and cannot be cut. Photo cannot be blurred. Do not use the flash on the camera.

Passport sample

Would you like to upload your passport photo now?*

Yes

Upload a passport photo*

Drop files here or

Max. file size: 8 MB, Max. files: 1.

!!! A passport photo is required to obtain a travel authorisation. If it is not possible to upload the passport photo at this time, you can send the passport photo later to the e-mail address info@usaestavisa.com !!!

Passport number*

Enter the number of your passport as it appears on the document. The number can contain letters and numbers.

Country that issued the passport*

Select the country that issued the passport.

Date of issuance of the passport*

Enter when the passport was issued.

Day

Month

Year

Date of expiration of the passport*

Enter the expiry date of the passport.

Day

Month

Year

ID card number*

Enter the number of your identity card. If you do not know, write “unknown”.

Have you been issued a passport or ID card to travel by another country?*

If this is the case, but the passport number is no longer known, enter “0000” as the number.

Yes

Issuing Country*

Select the country that issued the document.

Document type*

Select the document type.

Document number*

Enter your document number. If you do not know the number, enter “unknown”.

Year of expiration*

Enter the year in which the document expires or has expired.

Are you currently a citizen or national of another country?*

If so, state from which country and how you obtained it.

Yes

Citizenship / Nationality*

Select Citizenship or Nationality.

How did you obtain the citizenship / nationality of this country?*

Select how you obtained the citizenship or nationality of this country.

Other*

Please specify how else you obtained your citizenship or nationality.

Have you ever been a citizen or national of another country in the past?*

If yes, select the nationality and its duration.

Yes

Citizenship / Nationality*

Select citizenship or nationality

Since when*

Specify when you were a citizen or national of another country.

Day

Month

Year

Until when*

Specify when you were a citizen or national of another country.

Day

Month

Year

Are you a member of the GE/NEXUS/SENTRI program?*

If yes, enter your PASSID / membership number.

Yes

PASSID / member number*

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(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.)*