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U.S. Department of Justice
OMR 1115-4077
Immigration and Naturalization service
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美國司法部
OMR 1115-407
移民局
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Welcome to the United
State
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歡迎來到美國
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Admission Number
552738531 01
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登記號碼 (舉例說明)
552738531 01
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I-94 Arrival/Departure
Record-Instructions
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I-94 入境/離境記錄說明
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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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除了美國公民、美國海外僑民、永久居民和加拿大公民外，所有訪問或過境的人士都必須填寫此表。
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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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請用大寫字母打字或用筆填寫清楚。請用英文填寫。不要 在此表背面填寫任何東西。
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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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此表包括兩部分。請填寫入境記錄 (第1項至第13項)和離境記錄(第14項至第17項)兩部分。
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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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填寫完畢後，請將此表交給美國移民局官員。
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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項內容說明 - 如果您從陸地進入美國，請在空格內填寫LAND。如果 你乘船進入美國，請在空格內填寫SEA。
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Form I-94(10-01-85)N
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I-94表格 (10-01-85)N
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Admission Number
5527385031 01
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登記號碼
5527385031 01
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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
入境記錄
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1. Family Name
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1. 姓氏
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2. First (Given) Name
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2. 名字
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3. Birth Date (Day/Month/Year)
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3. 生日 (日/月/年)
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4. Country of Citizenship
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4. 國籍
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5. Sex (Male or Female)
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5. 性別 (男性或女性)
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6. Passport Number
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6. 護照號碼
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7. Airline & Flight Number
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7. 航空公司和航班
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8. Country Where You Live
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8. 您在哪個國家居住
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9. City Where You Boarded
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9. 您在哪個城市搭乘飛機
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10. City Where Visa Was Issued
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10. 在哪個城市取得簽證
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11. Date Issued (Day/Month/Year)
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11. 取得簽證的日期(日/月/年)
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12. Address While in the
United State
(Number and Street)
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12. 在美國的住址
(號碼及街名)
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13. City and State
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13. 在美國的住址 (城市及州名)
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Departure Number
552738531 01
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離境號碼
552738531 01
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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
離境記錄
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14. Family Name
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14. 姓氏
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15. First (Given) Name
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15. 名字
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16. Birth Date (Day/Month/Year)
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16. 生日 (日/月/年)
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17. County of Citizenship
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17. 國籍
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