U.S. Department of Justice
OMR 1115-4077
Immigration and Naturalization service |
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美国司法部
OMR 1115-407
移民局 |
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| Welcome to the United State |
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欢迎来到美国 |
Admission Number
233414639 09 |
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登记号码 (*举例说明)
233414639 09 |
| I-94 Arrival/Departure Record-Instructions |
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I-94 入境/离境记录说明 |
| This form must be completed by all persons except U.S. citizens, returning resident aliens with immigrant visas, and Canadian Citizens visiting or in transit. |
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除了美国公民, 美国海外侨民, 永久居民和加拿大公民外, 所有访问 或过路的人士都必须填写此表 |
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| Type or print legibly with pen in ALL CAPITAL LETTERS. Use English. Do not write on the back of this form. |
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请用大写字母打字或用钢笔或用圆珠笔清楚填写. 请用英文填写. 不要 在此表背面填写任何东西. |
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| This form is in two parts. Please complete both the Arrival Record (Item 1 through 13) and the Departure Record (Item 14 through 17). |
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此表包括两部分, 请填写入境记录 (第1项至第13项)和离境记录(第 14项至第17项)两部分. |
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| When all items are completed, present this form to the U.S. Immigration and Naturalization Service Inspector. |
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填写完毕后, 请将此表交给美国移民局官员. |
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| Item 7 – If you are entering the United States by land, enter LAND in this space. If you are entering the United States by ship, enter SEA in this space. |
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第7项内容说明 – 如果你从陆地进入美国, 请在空格内填写LAND, 如果 你乘船进入美国, 请在空格内填写SEA. |
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| Form I-94(10-01-85)N |
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I-94表 (10-01-85)N |
Admission Number
233414639 09 |
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登记号码
233414639 09 |
| Immigration and Naturalization Service |
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移民局 |
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I-94
Arrival Record |
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I-94
入境记录 |
| 1. Family Name |
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1. 姓 |
| 2. First (Given) Name |
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2. 名 |
| 3. Birth Date(Day/Mo/Yr) |
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3. 生日(月/日/年) |
| 4. Country of Citizenship |
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4. 哪个国家公民 |
| 5. Sex (Male or Female) |
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5. 性别(男填MALE或女填FEMALE) |
| 6. Passport Number |
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6. 护照号码 |
| 7. Airline & Flight Number |
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7. 航空公司和航班号 |
| 8. Country Where You Live |
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8. 你在哪个国家生活 |
| 9. City Where You Boarded |
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9. 你在那个城市登机 |
| 10. City Where Visa Was Issued |
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10. 在哪个城市得到签证 |
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| 11. Date Issued (Day/Mo/Yr) |
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11. 得到签证的日期(日/月/年) |
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| 12. Address While in the United State (Number and Street) |
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12. 在美国的住址(门牌号及街名) |
| 13. City and State |
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13. 在美国的住址(市名及州名) |
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Departure Number
233414639 09 |
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离境号码
233414639 09 |
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| Immigration and Naturalization Service |
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移民局 |
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I-94
Departure Record |
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I-94
离境记录 |
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| 14. Family Name |
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14. 姓 |
| 15. First (Given) Name 16. Birth Date(Day/Mo/Yr) |
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15. 名 16. 生日(日/月/年) |
| 17. County of Citizenship |
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17. 哪个国家公民 |