Required information for all passengers entering the United States of America
Department of Homeland Security
Federal Register/Vol. 70; No. 66; April 7, 2005; Rules and Regulations
The US Department of Homeland Security has enacted a law that requires all airlines to record and transmit personal information of its
passengers on flights entering the United States. In order to meet this requirement, we request that you completely fill out the form (one
for each passenger) in capital letters and submit it to the ground personnel upon check-in at least one hour before departure.
Please note that this information is absolutely mandatory in order to be granted entry into the United States of America by U.S. authorities.
Your information will be treated confidentially and not used for commercial purposes. This form will be destroyed after input in our check-in
Thank you for your understanding.
* Marked fields are mandatory
Flight Number / Date (DD-MM-YYYY) * / - -
US Destination *
Last name *
First name *
Given name *
Gender * Male / Female 1)
Date of birth (DD-MM-YYYY) * - -
Country of Residence *
Official Travel Document Type * Passport / Permanent or Alien Resident Card 1)
Official Travel Document Number *
Expiration Date of Official Travel Document *
Country of Issue *
Destination Address 2) Name of Hotel 3)
Street and Number *
City / Town *
Postal Code *
Country U S A
1) cross out, whichever is not applicable.
2) not applicable to US Citizens, holders of Legal Permanent or Alien Resident Cards & Transit Passengers
3) provide only if applicable