Application for a Republic of () Ordinary (for use of a national abroad or a national without household registration in Taiwan) Card No.’Card nototherisspacesapplicable. in Fill w Note: omission or unrecognizable part, the authority the part,may unrecognizable or omission Note: □None (decommissioned) Authority 1. Use two identical photographs taken within □Military personnel

The columns with redwith columns The are frames infilledthe au by six months: color, 35x45mm, front, without □Male at enlistment age hat, clear facial features, uncovered ears, □ at enlistment age neutral facial expressions, mouth closed Identity □Overseas Chinese near enlistment age (teeth not shown), white background, Date of Receipt glossy paper (without wearing color □Substitute service draftee eyeglasses except the visually impaired). □Male near enlistment age Paste one photograph here, and paste the Overseas Chinese status □Yes □No Passport No. other partially here. 2. The length from the top of the head to the □First-time Application □Renewal □Lost Replacement Date of Issue chin of the portrait should be between 32mm to 36mm. The head or hair must not Date of Expiry touch the edge of the photograph. Auditor's 3. When one wearing eyeglasses, the frames Notes herever is appropriate for the purposescontactthe appropriatefor is of herever must not cover any part of eyes (Please do Signature request the applicant for correction.fals any Onceapplicant the requestfor not wear heavy frame eyeglasses). 4. Photomontages are not allowed. thority 1. Name 1. Residential8. Status and Certificates Foreign □No Yes USA (country name) Passport . inotherfillAnc informationshould applicantin Chinese Name 林美華 Residence □No □Yes______(country name) Permit The name should be the same with the national ID card if applicable. English Name Visa Type______□No (Surname first) Credential LIN,MEI-HUA No. 4 3 2 1 5 6 7 8 9 1

(Fill in either (Please fill in the column in capital letters.) This should be the same with the previous passport. Please present of the above or emergency help.

ehood is found, the authority shall deal withdealitshallauthority in the found, is ehood certificate(s) when not using transliteration of Chinese name. three) Also Known As United States Issuing MAY LIN Department of State (Please fill in the column in capital letters.) Authority Please present certificate(s). olumns in black (or dark blue) with darkin(orblue) letters,olumns black block Domestic: Foreign: (yyyy/mm/dd) Province: City: Date of issue USA 2 0 0 7/0 9/0 5 2. Place of Birth (yyyy/mm/dd) Date of expiry (Name of Nation) 2 0 1 2/0 9/0 5 Information Residence9. Contact 3. Date of Birth (yyyy/mm/dd) 1 9 8 8/0 1/0 1 420 1 Wisconsin Ave., N W accordance law. with aretomust.F a 8 1 Sections 4. Sex □Male  Female Residence Washington, DC 20016, USA 5. National ID Card No. □□□□□□□□□□ Address Residence Permit No. □□□□□□□□□□

full and detailed.andfull orAbbreviations stylescursive of Taiwan ROC Phone (Office) 202-895-1800 6. Once a bearer of a Republic of China (Taiwan) passport or not? Number (Home) Yes □No (Mobile) (If Yes, please continue the following four columns) E-mail [email protected]

7. 10. Contact Information in Taiwan: Passport No. X 0 0 6 5 4 3 2 1 1 Contact Information Person's 王偉哲 of the most Name ill in ‘Nil’ill in knownif‘Alsoas’ IDorNational recent Passport date of issue Address in Republic of 10051 (yyyy/mm/dd) 1 9 9 8/0 6/2 0 Taiwan China 台北市中正區濟南路一段 2-2 號 (Taiwan) Date of expiry 2 0 0 4/0 6/2 0 are not allowed. If there is anyis there allowed. If not are passport (yyyy/mm/dd) 5 F Issuing authority Ministry of Foreign Affairs

Phone (Office) (02)2343-2888 

Yes Number (Home)

(Mobile)

□ E-mail No [email protected]

Please turn to the reverse side and continue. *For first-time applicants who do not have preferences for spellings, Scheme of the Chinese Phonetic Alphabets (Hanyu ) is recommended for transliterating the Chinese name into English. Yet, phonetic transcription of the "surname" should be the same with the ones of the relatives to avoid confusion. ______

f the registered f ewith. ewith. of delivery should delivery of e recipient's recipient's e y verified as partverified as y ______nd the information an identification t the originals for for originals the t nship certificate certificate nship for verification. verification. for ment(s) together together ment(s) I hereby declare thatdeclare I Ihereby received have passporta of of in fill (please thename thepassport bearer), a and portrait passporton the theshown carefull are theof applicant. Recipient's Signature:______Signature:______Agent's Phone Number:______Name:______Certificate Number:______Certificate the recipient*If is notapplicant the him/herself, shouldcertificate verification.presented be for one *When copya theby of applying mail, receipt o should ormail pasted the bedelivery th in express signature andcolumn other orblankdate the area, be indicated.

12. Recipient's Signature d’s Surname’ should be filled out and submitted her submitted and out filled be should Surname’ d’s te a parent's or a guardian's (the original guardia original (the guardian's a or parent's a te dentification certificate and present the original original the present and certificate dentification f proof (e.g. parent's nationality docu nationality parent's (e.g. proof nationality f when when cate for the Taiwan Area) inside the box and presen and box the inside Area) Taiwan the for cate pt when ould ould gistration gistration as been as ake the ake under the rtificates rtificates the guardian. □ the mother □ the father □ Father's Signature:______Or Mother's Signature:______Or Signature:______Guardian's Whether applying Whether inapplying the personsh not, or applicant Signature" exce sign onpersonally "Applicant’s the he/she is unable sign.to thatdeclare I thehereby information in,fill I ce and I t attachall photographs would are correct. I there responsibility is if any legal falsity. Signature______Applicant’s Signature authorizedof person______the If applicanthouseholdnational without is a re inanfor he/shepermit ROC, should apply entry/exit entering the country. It is hereby Itdeclared is thatis minor a hereby applicant the 20,of age and his/her passportapplicationa for h agreed by officially

11. Signature

verification. A copy of ‘Parent’s Agreement on Chil on Agreement ‘Parent’s of copy A verification. i the of copy verification) for presented be should For minor applicant under the age of 20, please pas please 20, of age the under applicant minor For

with applicant's birth certificate/Resident Certifi certificate/Resident birth applicant's with For the first-time applicant, please paste copies o copies paste please applicant, first-time the For

Note: Sections 11, 12 must be filled out.