Application for a Republic of () Ordinary (for use of a national abroad or a national without household registration in Taiwan)

Card No. Card authoritycorrection.the unrecognizablepart,applicant requestthe omissionfalsehoodor may Onceanyfor is Note: Note: □None (decommissioned) Authority 1. Use two identical photographs taken within □Military personnel

The columns withred columns The areframes filledin the authority by six months: color, 35x45mm, front, without □Male at enlistment age

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is notis applicable.other spacesFillin purposes appropriate isthe forwherever orcontact of emergency h 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 must not cover any part of eyes (Please do Signature not wear heavy frame eyeglasses). 4. Photomontages are not allowed.

1. 1. 8. Foreign □No Yes USA (country name)

Resid Name Passport

.

Anfillinshouldapplicant information Chinese Name 林美華 Residence No Yes______(country name) entialStatus and □ □

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.) Certificates This should be the same with the previous passport. Please present of the above certificate(s) when not using transliteration of Chinese name. three) Also Known As United States in othercolumnsinwithin dark(or black blue) letters,detailed.fullblock and orAbbreviations allow cursivestylesnot are Issuing found, the authoritywithshalldealaccordancethe itfound, in law. with MAY LIN Department of States Authority

elp (Please fill in the column in capital letters.)

. Please present certificate(s).

Domestic: Foreign: (yyyy/mm/dd) Province: City: Date of issue 2 0 0 7/0 9/0 5 2. Place of Birth USA (yyyy/mm/dd) Date of expiry (Name of Nation) 2 0 1 2/0 9/0 5

Information 9.

3. Date of Birth (yyyy/mm/dd) 1 9 8 8/0 1/0 1 ResidenceContact 420 1 Wisconsin Ave., N W 4. Sex □Male  Female Residence Washington, DC 20016, USA 5. National ID Card No. □□□□□□□□□□ Address Residence Permit No. □□□□□□□□□□ of Taiwan ROC Phone (Office) 202-895-1800

Sections 1 toare Sections1 8 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

a must.aFill in Passport No.

X 0 0 6 5 4 3 2 1 1 Contact Information in Taiwan: Information Person's 王偉哲 of the most Name recent Passport date of issue Address in Republic of 1 9 9 8/0 6/2 0 10051

‘ Nil China (yyyy/mm/dd) Taiwan

’ 台北市中正區濟南路一段 2-2 號

if (Taiwan) Date of expiry

‘

Alsoknown as 2 0 0 4/0 6/2 0 passport (yyyy/mm/dd) 5 F Issuing authority Ministry of Foreign Affairs

Phone (Office) (02)2343-2888

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ed. If there is anyis ed. there If

orIDNational Yes Number (Home)

(Mobile) □No E-mail [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. for for

s

together together

lly verified as part as verified lly document(s) guardianship certificate certificate guardianship submitted herewith. submitted and present the original the present and

original original filled out and and out filled

inside the box the inside parent's nationality parent's )

express delivery shouldpasted the in berecipient's delivery express e.g. (

should be be should

’ ertificate Number:______ertificate I hereby declare that I have received a passport of ______that passport of received a declare I have I hereby of the the inpassportandbearer), name information fill (please the passport on the andcarefu portrait are shown the the of applicant. Signature:______Recipient's Signature:______Agent's Phone Number:______Name:______Certificate C an identification the recipient applicant him/herself, is not *If the verification. shouldpresentedcertificate befor the the copy a of receipt of registered one by mail, *When applying ormail the should and delivery dateof the other blank signature column orarea, be indicated. proof

12. Recipient's Signature s Surname s ’

nationality of of been

e thee s copie , please paste a parent's or a guardian's (the (the guardian's a or parent's a paste please ,

ntry/exit permit when permit when ntry/exit s Signature" except when when except s Signature" ’ for the Taiwan Area Taiwan the for Certificate Resident / s Agreement on Child on Agreement s age of 20 of age ’ lease paste paste lease ______

Parent ‘

under the the under

s Signature_____ t's birth certificate birth t's A copy of of copy A time applicant, p applicant, time

- applicant first Guardian's Signature:______Guardian's Father's Signature:______Father's Or Mother's Signature:______Or It is hereby declared that the applicant is a minor under the underis minor a the declared thatapplicant It the is hereby 20, passporta of for application his/her andhasage □the father □the guardian.□the mother agreed by officially If the applicant is a national without household registration household the registration applicantnational If without is a an for e inhe/she should apply ROC, entering the country. Signature of Signatureauthorized of person______legal responsibility if there is any if falsity. responsibility legal Applicant’ sign personally on sign "Applicant personally the he/she is sign. unable to that in,declare the fill information I certificates hereby I tak I would all correct. andare attach photographs I Whether applying in person or not, the applicant should should thein applicant applying not, Whether person or applican

minor minor the the

11. Signature

should be presented for verification) copy of the identification certificate and present the original for verification. for original the present and certificate identification the of copy verification) for presented be should For

verification. with with For

Note: Sections 11, 12 must be filled out.