2024年4月10日发(作者：范妙芙)
美国入境I-94表(中英文对照)
Admission Number
471144200 09
Immigration and
Naturalization Service
I-94
Arrival Record 到达报告
1. Family Name 姓
2. First (Gicen) Name 名
3. Birth Date (day/mo/yr)
出生日期（日/月/年）
(Male or Female)
4. Country of Citizenship 国籍
性别（男或女）
C H I N E S E
rt Number 护照号 e and Flight Number
航
班
号
y Where You Live居住的国家 Where You Boarded居住的城市
C H I N A
Where Visa Was Issued获得签证的城市 Issued (day/mo/yr)
签证日期（日/月/年）
s While in the United States (Number and Street)在美地址（含街道和门牌
号）
and State（上述地址所在）城市和州
Admission Number
471144200 09
Immigration and
Naturalization Service
I-94 Departure Record 离境报告
1. Family Name 姓
2. First (Gicen) Name 名
4. Country of Citizenship 国籍
C H I N E S E
3. Birth Date
(day/mo/yr)
出生日期（日/月/年）
美国海关表(中英文对照)
1. Family Name 姓
First (Given) 名
Month月
Middle中间名
Year年
2. Birth date 出生日期 Day日
3. Number of Family Members traveling with you. 和你同行的家人人数
4. ⒜U.S. Street Address(hotel name/destination).在美国的地址（酒店名/目的地）
⒝City城市
5. Passport issued by (country)护照颁发国
6. Passport number护照号
7. Country of Residence居住国
8. Countries visited on this Trip prior to U.S. arrival
此次到美国之前访问的国家
9. Airline/Flight No. or Vessel Name 航班或船班号
CHINA
CHINA
NONE
⒞State州
10. The primary purpose of thip is business:这次旅行主要的目的是工作
11. I am (We are) bringing我（我们）携带了
⒜ fruits, plants, food, insects:水果，农产品，食品，昆虫
⒝ meats, animals, animal/wildlife products:肉类，动物，动物/野生动物制品
⒞ disease agents, cell cultures, snails: 蜜蜂制品，生物制品
⒟soil or have been on a farm/ranch/pasture:来自农场/牧场/草原的土壤
12. I have(we have) been in close proximity of (such as touching or handing) livestock:
我（我们）最近接近过牲畜。
Yes No
Yes
Yes
Yes
Yes
No
No
No
No
Yes No
13. I am (We are) carrying currency or monetary instruments over $10,000 foreign equivalents (see
definition of mone tary instruments on reverse)
我（我们）携带了超过10000美元或等值外币。 Yes No
14. I have (We have) commercial merchandise:（(articles for sale, samples used for soliciting orders, or goods
that are not considered personal effects)
我（我们）有商务货品（商品、样品或非个人使用的物品） Yes No
15. Residents – the total value of all goods, including commercial merchandise I/we have purchased or acquired
abroad, (including gifts for someone else, but not items mailed to the U.S.) and am/are bringing to the U.S. is:
美国公民——从国外购买或获得的商品（包括礼品）的总价值： $
Visitors – the total value of all articles that will remain in the U.S., including commercial
merchandise is:访问者——所有将留在美国的商品总价值： $
Read the instructions on the back of this form. Space is provided to list all the items you must
declare.参见本表背面的说明，并在空白出列出物品的清单。
IHAVE READ THE IMPORTANT INFORMATION ON THE REVERSE SIDE OF THIS FORM AND HAVE MADE A
TRUTHFUL DECLARATION.
我已阅读了本表背面的注意事项，并已如实申报。
(Signature)签名 Date (day/month/year)日期（日/月/年）
2024年4月10日发(作者：范妙芙)
美国入境I-94表(中英文对照)
Admission Number
471144200 09
Immigration and
Naturalization Service
I-94
Arrival Record 到达报告
1. Family Name 姓
2. First (Gicen) Name 名
3. Birth Date (day/mo/yr)
出生日期（日/月/年）
(Male or Female)
4. Country of Citizenship 国籍
性别（男或女）
C H I N E S E
rt Number 护照号 e and Flight Number
航
班
号
y Where You Live居住的国家 Where You Boarded居住的城市
C H I N A
Where Visa Was Issued获得签证的城市 Issued (day/mo/yr)
签证日期（日/月/年）
s While in the United States (Number and Street)在美地址（含街道和门牌
号）
and State（上述地址所在）城市和州
Admission Number
471144200 09
Immigration and
Naturalization Service
I-94 Departure Record 离境报告
1. Family Name 姓
2. First (Gicen) Name 名
4. Country of Citizenship 国籍
C H I N E S E
3. Birth Date
(day/mo/yr)
出生日期（日/月/年）
美国海关表(中英文对照)
1. Family Name 姓
First (Given) 名
Month月
Middle中间名
Year年
2. Birth date 出生日期 Day日
3. Number of Family Members traveling with you. 和你同行的家人人数
4. ⒜U.S. Street Address(hotel name/destination).在美国的地址（酒店名/目的地）
⒝City城市
5. Passport issued by (country)护照颁发国
6. Passport number护照号
7. Country of Residence居住国
8. Countries visited on this Trip prior to U.S. arrival
此次到美国之前访问的国家
9. Airline/Flight No. or Vessel Name 航班或船班号
CHINA
CHINA
NONE
⒞State州
10. The primary purpose of thip is business:这次旅行主要的目的是工作
11. I am (We are) bringing我（我们）携带了
⒜ fruits, plants, food, insects:水果，农产品，食品，昆虫
⒝ meats, animals, animal/wildlife products:肉类，动物，动物/野生动物制品
⒞ disease agents, cell cultures, snails: 蜜蜂制品，生物制品
⒟soil or have been on a farm/ranch/pasture:来自农场/牧场/草原的土壤
12. I have(we have) been in close proximity of (such as touching or handing) livestock:
我（我们）最近接近过牲畜。
Yes No
Yes
Yes
Yes
Yes
No
No
No
No
Yes No
13. I am (We are) carrying currency or monetary instruments over $10,000 foreign equivalents (see
definition of mone tary instruments on reverse)
我（我们）携带了超过10000美元或等值外币。 Yes No
14. I have (We have) commercial merchandise:（(articles for sale, samples used for soliciting orders, or goods
that are not considered personal effects)
我（我们）有商务货品（商品、样品或非个人使用的物品） Yes No
15. Residents – the total value of all goods, including commercial merchandise I/we have purchased or acquired
abroad, (including gifts for someone else, but not items mailed to the U.S.) and am/are bringing to the U.S. is:
美国公民——从国外购买或获得的商品（包括礼品）的总价值： $
Visitors – the total value of all articles that will remain in the U.S., including commercial
merchandise is:访问者——所有将留在美国的商品总价值： $
Read the instructions on the back of this form. Space is provided to list all the items you must
declare.参见本表背面的说明，并在空白出列出物品的清单。
IHAVE READ THE IMPORTANT INFORMATION ON THE REVERSE SIDE OF THIS FORM AND HAVE MADE A
TRUTHFUL DECLARATION.
我已阅读了本表背面的注意事项，并已如实申报。
(Signature)签名 Date (day/month/year)日期（日/月/年）