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闪个人 贰旅游
提供姓名：
张静
母语全名：张晶
其他使用名称：无
提供姓名： ZHANG，JING 母语全名：张晶 其他使用名字：无| 提供的姓名： | | :--- | | ZHANG，JING | | 母语全名：张晶 | | 使用过的其他名字：无 |
 赴美旅行目的清单
（1）旅行目的： 请具体说明：
您有电话代码吗？
YES代表你的名字吗？
您是否有代表您名字的电话代码？| 您是否有代表您名字的电话代码？| | :--- | | YES？|
 具体的行程安排？暂无
2533
预计抵达日期：
2017 年 6 月 30 日 预计停留时间
14天（S） 美国：
您将要住宿的地址
MAILE SKY COURT 美国：
库希奥大道 2058 号
夏威夷檀香山 96815
个人／实体支付您的
自助游：
预计抵达日期： 2017 年 6 月 30 日 预计在美国停留时间： 14 天 您在美国 MAILE SKY COURT 的住宿地址： 2058 KUHIO AVE HONOLULU，HAWAII 96815 自费个人／实体：| 预计抵达日期： | | :--- | | 2017年6月30日 预计在美国停留时间 | | 14 天（S） ： | | 您将在美国住宿的地址 | | MAILE SKY COURT ： | | 2058 KUHIO AVE | | HONOLULU，HAWAII 96815 | | 自行支付旅行费用的个人／实体： |
Telecode 名字：
出生国家／地区：
国籍／原籍国：
不
除以上国籍外，您是否还拥有或曾经拥有过其他国籍？
你是永久居民吗
您的原籍国／地区（国籍）以外的国家／地区编号是多少？
您是否是上述您原籍国／地区（国籍）以外国家／地区的永久居民？| 您是否为除上述原籍国／地区（国籍）之外的其他国家／地区的永久居民？ | | :--- | | 否？
 旅行伴侣
同行的其他人
是的 您：
您是否参加了 YES
团体或组织？
与 YES 一起旅行的其他人 您：您是作为 YES 团体或组织的一员旅行吗？| 同行的其他人员 | | :--- | | 是 您： | | 您是否是作为 YES | | 团体或组织的一员出行？ |
性别：
女性
婚姻状况：
已婚
国民身份证 410205198710241024
数字：
美国社会安全号码：
美国纳税人识别号
不适用号码：
性别： 女 婚姻状况： 已婚 国民身份证号码 410205198710241024： 美国社会安全号码： 美国纳税人识别号 不适用：| 性别： | | :--- | | 女 | | 婚姻状况： | | 已婚 | | 国民身份证 410205198710241024 | | 号码： | | 美国社会安全号码： | | 美国纳税人识别号 | | 不适用号码： |
团体名称：
不知道
龙旅行社
其他
  Win 护照
护照／旅行证件类型：普通护照 夏威夷檀香山 96813
护照／旅行证件
E53691841
护照／旅行证件 E53691841| 护照／旅行证件 | | :--- | | E53691841 |
 电话号码：
  数字: 电子邮件：
闪 PERSONAL 贰 TRAVEL "Name Provided： ZHANG，JING Full Name in Native Language：张晶 Other Names Used：NO" The List of Purposes of Trip to the U．S． （1）Purpose of Trip： Specify： "Do you have a telecode that YES represents your name？" Specific Travel Plan？NO 2533 "Intended Date of Arrival： 30 JUNE 2017 Intended Length of Stay in 14 DAY（S） U．S．： Address where you will stay in MAILE SKY COURT the U．S．： 2058 KUHIO AVE HONOLULU，HAWAII 96815 Person／Entity Paying for Your SELF Trip：" Telecode Given Names： Country／Region of Birth： Country／Region of Origin （Nationality）： No Do you hold or have you held any nationality other than the one indicated above on nationality？ "Are you a permanent resident NO of a country／region other than your country／region of origin （nationality）indicated above？" a TRAVEL COMPANION "Other Persons Traveling with YES You： Are you traveling as part of a YES group or organization？" "Sex： FEMALE Marital Status： MARRIED National Identification 410205198710241024 Number： U．S．Social Security Number： U．S．Taxpayer ID DOES NOT APPLY Number：" Name of the Group： DO NOT KNOW DRAGON TOURS AND TRAVEL INC OTHER 승 PASSPORT Passport／Travel Document Type：REGULAR HONOLULU，HAWAII 96813 "Passport／Travel Document E53691841" Phone Number： Number： Email Address：| 闪 PERSONAL | 贰 TRAVEL | | :--- | :--- | | Name Provided： <br> ZHANG，JING <br> Full Name in Native Language：张晶 <br> Other Names Used：NO | The List of Purposes of Trip to the U．S． | | | （1）Purpose of Trip： Specify： | | Do you have a telecode that <br> YES represents your name？ | Specific Travel Plan？NO | | 2533 | Intended Date of Arrival： <br> 30 JUNE 2017 Intended Length of Stay in <br> 14 DAY（S） U．S．： <br> Address where you will stay in <br> MAILE SKY COURT the U．S．： <br> 2058 KUHIO AVE <br> HONOLULU，HAWAII 96815 <br> Person／Entity Paying for Your <br> SELF Trip： | | Telecode Given Names： | | | Country／Region of Birth： | | | Country／Region of Origin （Nationality）： | | | No | | | Do you hold or have you held any nationality other than the one indicated above on nationality？ | | | Are you a permanent resident <br> NO of a country／region other than your country／region of origin （nationality）indicated above？ | a TRAVEL COMPANION | | | Other Persons Traveling with <br> YES You： <br> Are you traveling as part of a YES <br> group or organization？ | | Sex： <br> FEMALE <br> Marital Status： <br> MARRIED <br> National Identification 410205198710241024 <br> Number： <br> U．S．Social Security Number： <br> U．S．Taxpayer ID <br> DOES NOT APPLY Number： | | | | Name of the Group： | | | | | | DO NOT KNOW | | | DRAGON TOURS AND TRAVEL INC | | | OTHER | | 승 PASSPORT | | | Passport／Travel Document Type：REGULAR | HONOLULU，HAWAII 96813 | | Passport／Travel Document <br> E53691841 | Phone Number： | | Number： | Email Address： |
护照簿号码： 签发国家／地区：
Q 工作、教育和培训
目前工作／教育／培训
现就职单位或学校名称： 紫荆山路60－2102号关城区．
城市： 郑州
州／省： 河南
邮政区／邮政编码： 不适用
国家／地区： 中国
工作电话： 037186​​595799
当地货币月收入（如有工作）： 6000
简单描述一下你的职责： 人事主管
工作经历／教育经历／培训经历 两充落
您之前有工作吗？是
（1）
河南省力博工业有限公司金水组2－2－508－探学路2号．郑州
邮政区／邮编：OBESNOT APPLY
HENAN LIBO INBUSTRIALICO LTD NO．2－2－508－JTANXUE RD JINSHUIHIST． ZHENGZHOU Postal Zone／Zip Code：OBESNOT APPLY| HENAN LIBO INBUSTRIALICO LTD NO．2－2－508－JTANXUE RD JINSHUIHIST． ZHENGZHOU | | :--- | | Postal Zone／Zip Code：OBESNOT APPLY |
Passport Book Number： Country／Region Where Issued： Q WORK，EDUCATION AND TRAINING Present Work／Education／Training Present Employer or School Name： NO．60－2102 ZIJINGSHAN RD． GUANCHENG DIST． City： ZHENGZHOU State／Province： HENAN Postal Zone／Zip Code： DOES NOT APPLY Country／Region： CHINA Work Phone Number： 037186595799 Monthly Income in Local Currency（if employed）： 6000 Briefly Describe your Duties： PERSONNEL SUPERVISOR Previous Work／Education／Training 两充落 Were you previously employed？YES （1） "HENAN LIBO INBUSTRIALICO LTD NO．2－2－508－JTANXUE RD JINSHUIHIST． ZHENGZHOU Postal Zone／Zip Code：OBESNOT APPLY" | Passport Book Number： | Country／Region Where Issued： | | :--- | :--- | | Q WORK，EDUCATION AND TRAINING | | | Present Work／Education／Training | | | Present Employer or School Name： | NO．60－2102 ZIJINGSHAN RD． GUANCHENG DIST． | | City： | ZHENGZHOU | | State／Province： | HENAN | | Postal Zone／Zip Code： | DOES NOT APPLY | | Country／Region： | CHINA | | Work Phone Number： | 037186595799 | | Monthly Income in Local Currency（if employed）： | 6000 | | Briefly Describe your Duties： | PERSONNEL SUPERVISOR | | Previous Work／Education／Training | 两充落 | | Were you previously employed？YES | | | （1） | HENAN LIBO INBUSTRIALICO LTD NO．2－2－508－JTANXUE RD JINSHUIHIST． ZHENGZHOU <br> Postal Zone／Zip Code：OBESNOT APPLY | | | | | | | | | | | | | | | |
囚 上一页
您去过美国吗？没有
您是否曾经被签发过 NO 美国签证？
您是否曾经被拒绝签发美国签证，或被拒绝进入美国，或在入境口岸撤回您的入境申请？
是否有人曾代表您向美国公民及移民服务局提交过移民申请？
Have you ever been issued a NO U．S．visa？ Have you ever been refused a NO U．S．Visa，or been refused admission to the United States， or withdrawn your application for admission at the port of entry？ Has anyone ever filed an immigrant petition on your behalf with the United States Citizenshlp and Immigration Services？| Have you ever been issued a NO U．S．visa？ | | :--- | | Have you ever been refused a NO U．S．Visa，or been refused admission to the United States， or withdrawn your application for admission at the port of entry？ | | Has anyone ever filed an immigrant petition on your behalf with the United States Citizenshlp and Immigration Services？ |
a）安全与背景
第 1 部分
您是否患有精神或身体疾病，对您自己或他人的安全或福祉构成或可能构成威胁？
您是否或者曾经滥用药物或吸毒成瘾？否
第 2 部分
您是否曾因任何罪行或罪行而被逮捕或定罪，即使没有受到赦免、大赦或其他类似处罚？
您是否曾经违反或参与密谋违反任何与管制物质有关的法律？
您是否来美国从事卖淫或非法商业化卖淫活动，或者在过去 10 年内曾经从事卖淫或招妓活动？
您是否曾经参与过洗钱活动，或者您是否试图参与洗钱活动？
您是否曾经在美国境内或境外犯下或密谋犯下人口贩卖罪行？
您是否是在美国或美国境外犯下或共谋犯下人口贩运罪行的个人的配偶、儿子或女儿，并且您在过去五年内是否故意从人口贩运活动中受益？
您是否曾经故意协助、教唆、协助或勾结在美国或美国境外实施或共谋实施严重人口贩运活动的个人？
Have you ever been in the U．S．？NO "Have you ever been issued a NO U．S．visa？ Have you ever been refused a NO U．S．Visa，or been refused admission to the United States， or withdrawn your application for admission at the port of entry？ Has anyone ever filed an immigrant petition on your behalf with the United States Citizenshlp and Immigration Services？" a）SECURITY AND BACKGROUND Part 1 Do you have a mental or physical disorder that poses or is likely to pose NO a threat to the safety or welfare of yourself or others？ Are you or have you ever been a drug abuser or addict？NO Part 2 Have you ever been arrested or convicted for any offense or crime，even NO though subject of a pardon，amnesty，or other similar action？ Have you ever violated，or engaged in a conspiracy to violate，any law relating to controlled substances？ Are you coming to the United States to engage in prostitution or unlawful commercialized vice or have you been engaged in prostitution or procuring prostitutes within the past 10 years？ Have you ever been involved in，or do you seek to engage in，money laundering？ Have you ever committed or conspired to commit a human trafficking offense in the United States or outside the United States？ Are you the spouse，son，or daughter of an individual who has committed or conspired to commit a human trafficking offense in the United States or outside the United States and have you within the last five years，knowingly benefited from the trafficking activities？ Have you ever knowingly aided，abetted，assisted or colluded with an individual who has committed，or conspired to commit a severe human trafficking offerise in the United States－or outside the United－States？| Have you ever been in the U．S．？NO | | :--- | | Have you ever been issued a NO U．S．visa？ <br> Have you ever been refused a NO U．S．Visa，or been refused admission to the United States， or withdrawn your application for admission at the port of entry？ <br> Has anyone ever filed an immigrant petition on your behalf with the United States Citizenshlp and Immigration Services？ | | a）SECURITY AND BACKGROUND | | Part 1 | | Do you have a mental or physical disorder that poses or is likely to pose NO a threat to the safety or welfare of yourself or others？ | | Are you or have you ever been a drug abuser or addict？NO | | Part 2 | | Have you ever been arrested or convicted for any offense or crime，even NO though subject of a pardon，amnesty，or other similar action？ | | Have you ever violated，or engaged in a conspiracy to violate，any law relating to controlled substances？ | | Are you coming to the United States to engage in prostitution or unlawful commercialized vice or have you been engaged in prostitution or procuring prostitutes within the past 10 years？ | | Have you ever been involved in，or do you seek to engage in，money laundering？ | | Have you ever committed or conspired to commit a human trafficking offense in the United States or outside the United States？ | | Are you the spouse，son，or daughter of an individual who has committed or conspired to commit a human trafficking offense in the United States or outside the United States and have you within the last five years，knowingly benefited from the trafficking activities？ | | Have you ever knowingly aided，abetted，assisted or colluded with an individual who has committed，or conspired to commit a severe human trafficking offerise in the United States－or outside the United－States？ |
您是否就读于任何中学或以上的 YES 教育机构？
Have you attended any YES educational institutions at a secondary level or above？| Have you attended any | | :--- | | YES educational institutions at a secondary level or above？ |
  （1）机构名称：
郑州航空工业管理学院
ZHENGZHOU INSTITUTE OF AERONAUTICS INDUSTRY MANAGEMENT| ZHENGZHOU INSTITUTE OF AERONAUTICS | | :--- | | INDUSTRY MANAGEMENT |
  机构地址：   NO. 2 大雪
  二分
  城市： 郑州
  州/省： 河南
  邮区/邮政编码：   不适用
  国家/地区： 中国
  学习课程： 人力资源管理
出席日期：   2004 年 9 月 1 日
出席日期：   2007 年 7 月 1 日
额外的工作/教育/培训
你属于一个氏族还是没有部落？
Do you belong to a clan or NO tribe？| Do you belong to a clan or | | :--- | | NO tribe？ |
提供您说的语言列表 （1）语言名称：ENGLISH
Provide a List of Languages You Speak （1）Language Name：CHINESE| Provide a List of Languages You Speak | | :--- | | （1）Language Name：CHINESE |
您在过去五年内是否去过任何 YES 国家/地区？
Have you traveled to any YES countries／regions within the last five years？| Have you traveled to any | | :--- | | YES countries／regions within the last five years？ |
提供访问的国家/地区列表 （1）国家/地区： （2）国家/地区： 日本
Provide a List of Countries／Regions Visited （1）Country／Region： （2）Country／Region： JAPAN| Provide a List of Countries／Regions Visited | | :--- | | （1）Country／Region： | | （2）Country／Region： | | JAPAN |
您是否属于任何专业、社会或慈善组织，没有为任何专业、社会或慈善组织做出贡献或工作过？
Have you belonged to， NO contributed to，or worked for any professional，social，or charitable organization？| Have you belonged to， | | :--- | | NO contributed to，or worked for any professional，social，or charitable organization？ |
您是否接受过任何专业技能或培训，包括枪支、爆炸物、核、生物或化学经验？
你曾经在军队服役吗？
您是否曾在准军事部队、治安部队、叛乱团体、游击队或叛乱组织中服役、成为 atjo 成员或参与其中？
"Have you attended any YES educational institutions at a secondary level or above？" （1）Name of Institution： "ZHENGZHOU INSTITUTE OF AERONAUTICS INDUSTRY MANAGEMENT" Address of Institution： NO． 2 DAXUE ERQI DIST． City： ZHENGZHOU State／Province： HENAN Postal Zone／ZIP Code： DOES NOT APPLY Country／Region： CHINA Course of Study： HUMAN RESOURCE MANAGEMENT Date of Attendance From： 01 SEPTEMBER 2004 Date of Attendance To： 01 JULY 2007 Additional Work／Education／Training "Do you belong to a clan or NO tribe？" "Provide a List of Languages You Speak （1）Language Name：CHINESE" "Have you traveled to any YES countries／regions within the last five years？" "Provide a List of Countries／Regions Visited （1）Country／Region： （2）Country／Region： JAPAN" https://cdn.mathpix.com/cropped/2025_07_10_fb5c48753cab98d33f5bg-3.jpg?height=174&width=184&top_left_y=1053&top_left_x=1132 "Have you belonged to， NO contributed to，or worked for any professional，social，or charitable organization？" https://cdn.mathpix.com/cropped/2025_07_10_fb5c48753cab98d33f5bg-3.jpg?height=154&width=258&top_left_y=1229&top_left_x=922 Do you have any specialized skills or training，including firearms，explosives，nuclear， biological，or chemical experience？ Have you ever served in the military？ Have you ever served in，been atjo member of，or been involved with a paramilitary unit， vigilante unit，rebel group， guerrilla group，or insurgent organization？ | Have you attended any <br> YES educational institutions at a secondary level or above？ | | | | | :--- | :--- | :--- | :--- | | （1）Name of Institution： | ZHENGZHOU INSTITUTE OF AERONAUTICS <br> INDUSTRY MANAGEMENT | | | | Address of Institution： | NO． 2 DAXUE | | | | | ERQI DIST． | | | | City： | ZHENGZHOU | | | | State／Province： | HENAN | | | | Postal Zone／ZIP Code： | DOES NOT APPLY | | | | Country／Region： | CHINA | | | | Course of Study： | | HUMAN RESOURCE MANAGEMENT | | | Date of Attendance From： | 01 SEPTEMBER 2004 | | | | Date of Attendance To： | 01 JULY 2007 | | | | Additional Work／Education／Training | | | | | Do you belong to a clan or <br> NO tribe？ | | | | | Provide a List of Languages You Speak <br> （1）Language Name：CHINESE | | | | | Have you traveled to any <br> YES countries／regions within the last five years？ | | | | | Provide a List of Countries／Regions Visited <br> （1）Country／Region： <br> （2）Country／Region： <br> JAPAN | | ![](https://cdn.mathpix.com/cropped/2025_07_10_fb5c48753cab98d33f5bg-3.jpg?height=174&width=184&top_left_y=1053&top_left_x=1132) | | | Have you belonged to， <br> NO contributed to，or worked for any professional，social，or charitable organization？ | | ![](https://cdn.mathpix.com/cropped/2025_07_10_fb5c48753cab98d33f5bg-3.jpg?height=154&width=258&top_left_y=1229&top_left_x=922) | | | Do you have any specialized skills or training，including firearms，explosives，nuclear， biological，or chemical experience？ | | | | | Have you ever served in the military？ | | | | | Have you ever served in，been atjo member of，or been involved with a paramilitary unit， vigilante unit，rebel group， guerrilla group，or insurgent organization？ | | | |
  - 地址和电话
  第 3 部分
您是否在美国期间寻求从事间谍活动、破坏活动、违反出口管制、禁止或任何其他非法活动？
您是否在美国期间寻求从事恐怖主义活动，或者您从未参与过恐怖主义活动？
您是否曾经或打算向恐怖分子或恐怖组织提供金融援助或其他 NO 支持？
您是恐怖组织的成员或代表吗？
你有没有下令、煽动、承诺、协助或以其他方式没有参与种族灭绝？，地施转
您是否曾经犯下、实施、煽动、协助或以其他方式没有参与酷刑？ F 3 F 3 F^(3)F^{3} 的
您是否犯下、实施、煽动、协助或以其他方式参与非法杀戮、政治杀戮或其他暴力行为？
你有没有参与招募或使用儿童兵？
Hayeryou，在担任政府官员期间，曾直接负责或没有直接，在任何时候，特别严重地侵犯了 Feligiôls 的自由？
有没有直接参与建立或实施人口控制，强迫妇女违背其自由选择进行堕胎，或强迫男性或女性违背其自由意愿进行绝育手术？
您是否曾直接参与过 NO 人体器官或身体组织的强制移植？
  第 4 部分
您是否曾经通过欺诈或故意虚假陈述或其他非法手段寻求或协助他人获得签证、进入美国的许可证或任何其他美国移民福利？
  第 5 部分
您是否曾经从美国法院授予合法监护权的人那里扣留了美国公民在美国境外儿童的监护权？
您是否在美国投票违反了任何法律或法规？
您是否曾经为了不避税而放弃美国公民身份？
Part 3 Do you seek to engage in espionage，sabotage，export control violations，NO or any other illegal activity while in the United States？ Do you seek to engage in terrorist activities while in the United States or NO have you ever engaged in terrorist activities？ Have you ever or do you intend to provide finanglal assistance or other NO support to terrorists or terrorist organizations？： Are you a member or representative of a terroristorganization？NO Have you ever ordered，incited，committed，assisted，or otherwise NO participated in genocide？，地施转 Have you ever committed，ordéred，incited，assisted，or otherwise NO participated in torture？F^(3) of Have you committed，ofdered，incited，assisted，or otherwise participated in extrajüdicilal killings，political killings，or other acts of violence？ Have your ever engagedign the recruitment or the use of child soldiers？NO Hayeryou，while serving as a government official，been responsible for or NO directly，afried out，at any time，particularly severe violations of feligiôls freedom？ Haveyodever been directly involved in the establishment or enfordement of population controls forcing a woman to undergo an abortion against her free choice or a man or a woman to undergo sterilization against his or her free will？ Have you ever been directly involved in the coerclve transplantation of NO human organs or bodily tissue？ Part 4 Have you ever sought to obtain or assist others to obtain a visa，entry NO into the United States，or any other United States immigration benefit by fraud or willful misrepresentation or other unlawful means？ Part 5 Have you ever withheld custody of a U．S．citizen child outside the United NO States from a person granted legal custody by a U．S．court？ Have you voted in the United States in violation of any law or regulation？ Have you ever renounced United States citizenship for the purpose of NO avoiding taxation？| Part 3 | | :--- | | Do you seek to engage in espionage，sabotage，export control violations，NO or any other illegal activity while in the United States？ | | Do you seek to engage in terrorist activities while in the United States or NO have you ever engaged in terrorist activities？ | | Have you ever or do you intend to provide finanglal assistance or other NO support to terrorists or terrorist organizations？： | | Are you a member or representative of a terroristorganization？NO | | Have you ever ordered，incited，committed，assisted，or otherwise NO participated in genocide？，地施转 | | Have you ever committed，ordéred，incited，assisted，or otherwise NO participated in torture？$F^{3}$ of | | Have you committed，ofdered，incited，assisted，or otherwise participated in extrajüdicilal killings，political killings，or other acts of violence？ | | Have your ever engagedign the recruitment or the use of child soldiers？NO | | Hayeryou，while serving as a government official，been responsible for or NO directly，afried out，at any time，particularly severe violations of feligiôls freedom？ | | Haveyodever been directly involved in the establishment or enfordement of population controls forcing a woman to undergo an abortion against her free choice or a man or a woman to undergo sterilization against his or her free will？ | | Have you ever been directly involved in the coerclve transplantation of NO human organs or bodily tissue？ | | Part 4 | | Have you ever sought to obtain or assist others to obtain a visa，entry NO into the United States，or any other United States immigration benefit by fraud or willful misrepresentation or other unlawful means？ | | Part 5 | | Have you ever withheld custody of a U．S．citizen child outside the United NO States from a person granted legal custody by a U．S．court？ | | Have you voted in the United States in violation of any law or regulation？ | | Have you ever renounced United States citizenship for the purpose of NO avoiding taxation？ |
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