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USA ESTA Sign Up Information

Last Updated:

7/6/2020 1

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Data Held

Email Address

Username

Your Name

First Name, Last Name

Your Address

Home Address, City, State, Country

Phone Number

Phone

Post-Registration Data

We are still gathering data about this website

Validation

This site did not show evidence of storing passwords in plaintext.

This site does allow secured connections (https)

This site did show a clear way to unsubscribe from their emails

This site does verify your email address.

Membership Emails

Below is a sample of the emails you can expect to receive when signed up to USA ESTA.

Complete your ESTA Visa Applic...

Jackson,

Your application to obtain a Travel Authorization to the USA under the Visa Waiver Program has not been completed properly.

The processing of your ESTA Authorization begins upon receipt of your payment.

Below you will find a link to complete your payment. Once your payment is received you will receive your approved Travel Authorization.

https://usaesta.co.uk/apply-for-esta/?do=continue&auth=1d6e4ebcd832f8a80951ea230ef82242d21e466adfadef1f084b6d3a96dd7259

If you have already successfully paid for your application, please discard this email. You will receive your approved ESTA document, shortly.

Best Regards

usaesta.co.uk

Raw Data Registration Structure Registration Form Text

Registration

Indicate whether you are known by any other names or aliases by selecting yes or no. Are you known by any other names or aliases? *

First name

Last name

Title

Username

Phone

Home address

City

State

Country

Gender

Please note: 1. Each traveler should complete its own ESTA application. 2. A valid passport and a credit card are required to successfully complete the form. 3. The mandatory fields are marked by red asterisks *. Please, provide the needed information below. PLEASE FILL OUT THE FOLLOWING TRAVEL AUTHORIZATION INFORMATION: Choose your gender, either male or female. Gender *

Female

Indicate whether you are known by any other names or aliases by selecting yes or no. Are you known by any other names or aliases? *

Day

If you have never been issued any one of these documents by any other country answer "No" to this question. If you have been issued one of these documents from another country, but you do not remember the passport number or national identification card number and the year of expiration answer "UNKNOWN" in the passport number field. Have you ever been issued a passport or national identity card for travel by any other country? *

Day

OTHER CITIZENSHIP/NATIONALITY If Yes, select the country first, then select how you acquired the citizenship/nationality. Are you now, a citizen or national of any other country?* *

Day

"Previous" means at any time in the past, without limitation. Have you ever been a citizen or national of any other country? *

Day

-- AUSTRALIA (AUS) AFGHANISTAN (AFG) ALAND ISLANDS (ALA) ALBANIA (ALB) ALGERIA (DZA) AMERICAN SAMOA (ASM) ANDORRA (AND) ANGOLA (AGO) ANGUILLA (AIA) ANTARCTICA (ATA) ANTIGUA AND BARBUDA (ATG) ARGENTINA (ARG) ARMENIA (ARM) ARUBA (ABW)

Did not acquire citizenship at birth or have never held citizenship in birth country

Renounced citizenship of birth country

Have not lived or resided in birth country within the past five years

Have not held a passport or national identity card from birth country within the past five years

Day

Travel information Indicate whether your travel to the US is occurring in transit to another country by selecting yes or no. Is your travel to the USA occurring in transit to another country? *

Day

Occupational information Indicate whether you have a current or previous employer by selecting yes or no. Do you presently or in the past work for a corporation / business? *

Day

GE MEMBERSHIP If you answer Yes to the question, please enter your PASSID/Membership Number. Are you a member of the CBP Global Entry Program? *

Please answer with Yes or No to the following questions Do you have a communicable disease; physical or mental disorder; or are you a drug abuser or addict?

Yes Communicable Diseases Under United States law, communicable diseases of public health significance include: Chancroid Gonorrhea Granuloma inguinale Leprosy, infectious Lymphogranuloma venereum Syphilis, infectious stage Tuberculosis, active Have you ever been arrested or convicted for a crime that resulted in serious damage to property, or serious harm to another person or government authority?

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

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

Yes Have you ever committed fraud or misrepresented yourself or others to obtain, or assist others to obtain a visa or entry into the USA?

Yes Are you currently seeking employment in the United States or where you previously employed in the USA without prior permission from the US government?

Yes Have you ever been refused a US visa or entry or had a visa revoked? If yes, please elaborate when and where?

Have you ever stayed in the United States longer than the admission period granted to you by the US government?

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

Yes

I accept the Terms and Conditions *

Data Name	Data Type	Options
Indicate whether you are known by any other names or aliases by selecting yes or no. Are you known by any other names or aliases? *	Text Box
First name	Text Box
Last name	Text Box
Title	Text Box
Username	Text Box
Email	Text Box
Phone	Text Box
Home address	Text Box
City	Text Box
State	Text Box
Country	Text Box
Gender	Text Box
	option	Please note: 1. Each traveler should complete its own ESTA application. 2. A valid passport and a credit card are required to successfully complete the form. 3. The mandatory fields are marked by red asterisks . Please, provide the needed information below. PLEASE FILL OUT THE FOLLOWING TRAVEL AUTHORIZATION INFORMATION: Choose your gender, either male or female. Gender
	option	Female
	option	Indicate whether you are known by any other names or aliases by selecting yes or no. Are you known by any other names or aliases? *
	option	No
	dropdown	Day
	dropdown	Day
	dropdown	Day
	dropdown	Day
	dropdown	Day
	dropdown	Day
	dropdown	Day
	dropdown	Day
	dropdown	Day
	dropdown	Day
	dropdown	Day
	option	If you have never been issued any one of these documents by any other country answer "No" to this question. If you have been issued one of these documents from another country, but you do not remember the passport number or national identification card number and the year of expiration answer "UNKNOWN" in the passport number field. Have you ever been issued a passport or national identity card for travel by any other country? *
	option	No
	dropdown	Day
	dropdown	Day
	option	OTHER CITIZENSHIP/NATIONALITY If Yes, select the country first, then select how you acquired the citizenship/nationality. Are you now, a citizen or national of any other country?* *
	option	No
	dropdown	Day
	dropdown	Day
	option	"Previous" means at any time in the past, without limitation. Have you ever been a citizen or national of any other country? *
	option	No
	dropdown	Day
	checklist	-- AUSTRALIA (AUS) AFGHANISTAN (AFG) ALAND ISLANDS (ALA) ALBANIA (ALB) ALGERIA (DZA) AMERICAN SAMOA (ASM) ANDORRA (AND) ANGOLA (AGO) ANGUILLA (AIA) ANTARCTICA (ATA) ANTIGUA AND BARBUDA (ATG) ARGENTINA (ARG) ARMENIA (ARM) ARUBA (ABW)
	checklist	Did not acquire citizenship at birth or have never held citizenship in birth country
	checklist	Renounced citizenship of birth country
	checklist	Have not lived or resided in birth country within the past five years
	checklist	Have not held a passport or national identity card from birth country within the past five years
	dropdown	Day
	dropdown	Day
	option	Travel information Indicate whether your travel to the US is occurring in transit to another country by selecting yes or no. Is your travel to the USA occurring in transit to another country? *
	option	No
	dropdown	Day
	dropdown	Day
	option	Occupational information Indicate whether you have a current or previous employer by selecting yes or no. Do you presently or in the past work for a corporation / business? *
	option	No
	dropdown	Day
	option	GE MEMBERSHIP If you answer Yes to the question, please enter your PASSID/Membership Number. Are you a member of the CBP Global Entry Program? *
	option	No
	option	Please answer with Yes or No to the following questions Do you have a communicable disease; physical or mental disorder; or are you a drug abuser or addict?
	option	No
	option	Yes Communicable Diseases Under United States law, communicable diseases of public health significance include: Chancroid Gonorrhea Granuloma inguinale Leprosy, infectious Lymphogranuloma venereum Syphilis, infectious stage Tuberculosis, active Have you ever been arrested or convicted for a crime that resulted in serious damage to property, or serious harm to another person or government authority?
	option	No
	option	Yes Have you ever violated any law related to possessing, using, or distributing illegal drugs?
	option	No
	option	Yes Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide?
	option	No
	option	Yes Have you ever committed fraud or misrepresented yourself or others to obtain, or assist others to obtain a visa or entry into the USA?
	option	No
	option	Yes Are you currently seeking employment in the United States or where you previously employed in the USA without prior permission from the US government?
	option	No
	option	Yes Have you ever been refused a US visa or entry or had a visa revoked? If yes, please elaborate when and where?
	option	No
	option	Have you ever stayed in the United States longer than the admission period granted to you by the US government?
	option	No
	option	Yes Have you traveled to, or been present in Iraq, Syria, Iran, Sudan, Libya, Somalia or Yemen on or after March 1, 2011?
	option	No
	checklist	Yes
	checklist	I accept the Terms and Conditions *