AUTHORIZATION APPROVED

Your travel authorization has been approved and you are authorized to travel to the United States under the
Visa Waiver Program. This does not guarantee admission to the United States; a Customs and Border
Protection (CBP) officer at a port of entry will have the final determination.

APPLICATION NUMBER EXPIRATION DATE

R920I59H3770W7H7 11/09/2022

PAYMENT RECEIPT
Payment Date:
November 30, 2020 12:32:5 PM
Payment Tracking Code:
26QIN40Q
Payment Received:
$14.00

APPLICANT INFORMATION
Family Name
STEINBISS
First (Given) Name
ANGELIKA
Gender
Female
Date of Birth
March 21, 2010
City of Birth
DESSAU-ROBLAU
Country of Birth
GERMANY (DEU)
Passport Number
C6JTPC3KZ
Country of Citizenship
GERMANY (DEU)
National Identification Number
C6JTPC3KZ
Issuance Date
November 10, 2016
Issuing Country
GERMANY (DEU)
Personal Identification Number
Expiration Date
November 9, 2022

OTHER CITIZENSHIP/NATIONALITY
Are you now, a citizen or national of any other country?No
Have you ever been a citizen or national of any other country?No

E-mail Address
COPYSMARTRD@GMAIL.COM
Confirm E-mail Address
COPYSMARTRD@GMAIL.COM

PERSONAL INFORMATION
Are you known by any other names or aliases?No
Have you ever been issued a passport or national identity card for travel by any other
country?No

YOUR CONTACT INFORMATION

Address Line 1
06686 LUTH KARL-MARX
Address Line 2
Apartment Number
City
WITTENBERG
State/Province/Region
WITTENBERG
Country
GERMANY (DEU)
Telephone Type
Work
Country Code
DOMINICAN REPUBLIC (DOM) (+1)
Phone Number
8294779586

SOCIAL MEDIA
Provider / Platform
Social Media Identifier

GE MEMBERSHIP
Are you a member of the CBP Global Entry Program?No

PARENTS
Family Name
DIAZ
First (Given) Name
ANGELA
Family Name
HENRY HORST
First (Given) Name
PETER

EMPLOYMENT INFORMATION
Do you have a current or previous employer?No

TRAVEL INFORMATION
Is your travel to the US occurring in transit to another country?No
U.S. Point of Contact Information
Name
JUDITH SANCHEZ
Address Line 1
70 EAST 115
Address Line 2
Apartment Number
City
MANHATTAN
State/Province/Region
NEW YORK
Country Code
UNITED STATES (USA) (+1)
Phone Number
3479843511
Address While in the U.S.
Address Line 1
70 EAST 115
Address Line 2
Apartment Number
City
MANHATTAN
State/Province/Region
NEW YORK
EMERGENCY CONTACT INFORMATION IN OR OUT OF THE U.S.
Family Name
SANCHEZ
First (Given) Name
JUDITH
E-mail Address
BUENOSNET@GMAIL.COM
Country Code
UNITED STATES (USA) (+1)
Phone Number
3479843511