USA Visa Online Application Form

1. Submit Application Online
2. Review and Confirm Payment
3. Receive Approved US Visa

Enter all information in English

Personal Details

Family/last name *

Family name is also known as Last name or Surname
Enter ALL name(s) as they appear on your passport.

First/Given Names *

Please provide your first name(s) (also known as "given name") exactly as shown on your passport or identity document.

Ensure that the full name given below (includes any middle names) is in English and matches exactly the name in your passsport.

Gender *

Date of Birth *

Place of Birth *

Enter the name of the city/town/village shown in the place of birth field on your passport. If there is no city/town/village on your passport, enter the name of the city/town/village where you were born.

Country of Birth *

From the drop-down menu, select the name of the country shown in the Place of birth field on your passport.

Email Address *

You will receive an email that confirms the receipt of your Application at the email address you provide.

Confirm Email Address *

Marital Status *

Country of Citizenship *

Passport Details

Provide details of the passport that you will use to enter United States. Enter these details exactly as they appear in your passport.

Issuing Country of Passport *

The Country of Passport must match Country of the Citizenship. If you need to change Country of Passport, update Country of Citizenship.

Passport Number *

Enter the passport number exactly as it appears on the biographic information page. Pay particular attention to the letter O and the number 0; and the letter I and the number 1.

Confirm Passport Number *

Re-enter Passport Number to confirm.

Passport Date of Issue *

Passport Expiry Date *

Please note that for this trip, you must use a passport issued by the Ministry of Foreign Affairs in Taiwan.

Taiwan Personal Identification Number (as given in passport) *

Please enter the ID number listed in your Passport.

Identity number or I.D. number in the Passport *

The ID number looks like 3-1237682-9.

Chilean National Identification Number *

The RUN or RUT has 7 or 8 digits

In the past have you ever been citizen of any other country?*

Yes No

Country of Past Citizenship *

Start date of Previous Citizenship or Nationality *

End date of Previous Citizenship or Nationality *

Passport Number from Previous Citizenship *

Expiry year of Passport from Previous Citizenship *

Are you currently a citizen or national of any other country?*

Yes No

Country of Dual Citizenship *

How did you acquire dual citizenship? *

Passport number from Dual Citizenship *

Expiry year of passport from Dual Citizenship *

ADDRESS DETAILS

Home Address line 1 *

Home Address line 2 (optional)

Town or City *

State or Province or District *

Postal / ZIP Code *

Country of Residence *

Mobile/Phone Number *

UNITED STATES POINT OF CONTACT DETAILS

If you do not have any contact in the United States, you can enter contact information for your place of stay in the US. If you do not have address details for place of stay at this point of time, enter UNKNOWN.

Full name of Contact *

Contact Address Line 1 *

Contact Address Line 2

City *

State *

Mobile/Phone Number *

Travel and Employment Details

Purpose of Visit *

Please enter purpose of your visit

Expected Date of Arrival *

Visa validity will start from the Visa Issue Date.

Do you have a current or previous employer?*

Yes No

Employer or Company Name *

Job Title (optional)

Employer Address Line 1 *

Employer Address Line 2 (optional)

Town or City of Employment

State or District of Employment

Country of Employment *

Parent Details

Father's Family Name *

Father's First / Given Name

Mother's Family Name *

Mother's First / Given Name

Eligibility Details

If you answer Yes to any of the questions below, you are not eligible to apply for ESTA USA Visa online and you will need to contact your nearest US consulate or embassy.

Have you ever been arrested or convicted for a crime that resulted in serious damage to property, or serious harm? *

Yes No

Have you ever violated any law related to possessing, using, or distributing illegal drugs? *

Yes No

Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide? *

Yes No

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

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

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

Have you ever stayed in the United States longer than the admission period granted to you by the U.S. government? *

Yes No

Have you traveled to, or been present in Cuba, Iran, Iraq, Libya, North Korea, Somalia, Sudan, Syria or Yemen on or after March 1, 2011? *

Yes No

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.

Yes No

UPLOAD PASSPORT

Provide your passport

Provide an acceptable photo of your passport information page. Alternatively, you can skip upload right now and receive instructions on how to send it later via email.

Are you able to upload passport right now*

Yes No

You can either upload a recent photo of passport or use your device's camera to take a photo.

Passport Requirements

- Passport photo/scan must be clear and of good quality and high resolution.
- You can upload your Passport scan in the following file formats: PDF, PNG, and JPG.
- The Passport scan shouldn’t be blurred.
- The MRZ (the two strips at the bottom of the Passport) should be clearly visible.

Upload Your Passport

× Only the following file types are permitted: jpeg, jpg, png, pdf.

× Success! Passport successfully submitted.

As recommended by U.S. Customs and Border Protection, you are required to provide a passport to complete your application. Without this documentation, your ESTA will not be processed and will remain pending. You will recieve an email with instructions on how to send us through your passport.

You have already tried uploading a maximum of three (3) times. Please email your passport to Help Desk

Declaration by Applicant

I declare that the information I have given in this application is truthful, complete and correct.

I have read and understood the terms and conditions, refund policy and privacy policy.

Proceed to payment

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