Speedy Immigration Inspection Certificate for Foreign Frequent Visitors

Applicant Information
First Name/Given Name
Last Name/Family Name
Date of Birth (format yyyy/mm/dd)
Sex Male Female
Nationality
Email Address
Home Address
Cell Phone Number (format 09-12345678)
Home Telephone Number Telephone Country Code  +
Telephone Number  (format 123456789)
Document Information
Passport Number
Passport Issuing Country
Passport Issuance Date (format yyyy/mm/dd)
Passport Expiration Date (format yyyy/mm/dd)
Identity Card Number
Visa Type
Visa Number
Recent 3 times to visit Taiwan in 1 year Information
Another Passport NO, I have used the only passport coming to Taiwan in past 12 months.

YES, I have used the other passport coming to Taiwan in past 12 months.
(NOTE:If you choose YES, you have to fill in the other(old) passport number)
Other(Old) Passport Number
Entry Date 1 (format yyyy/mm/dd)
Entry Date 2 (format yyyy/mm/dd)
Entry Date 3 (format yyyy/mm/dd)
Hong Kong and Macau, mainland chinese residents please fill in the fields below.
Permit Number
Permit Issuance Date (format yyyy/mm/dd)
Permit Expiry Date (format yyyy/mm/dd)
Other Information
Purpose of Visit
Address in Taiwan or Hotel Name
Telephone Number in Taiwan(option) (format 09-12345678)
Verify Code 點擊重新整理圖片