Affidavit for Global Entry

AFFIDAVIT FOR GLOBAL ENTRY

State of:   County of:

Affiant Name:   Date of Birth:

Passport/ID Number:   Issuing Country/State:

Current Address:

RECITALS

WHEREAS, Affiant is the individual identified above and is applying for enrollment in the Trusted Traveler Program commonly known as Global Entry for expedited processing at certain ports of entry; and

WHEREAS, an application for Global Entry requires the submission of a sworn affidavit confirming the accuracy of identifying information, authorizing background checks and exchange of biographic and biometric information with law enforcement and border control authorities, and attesting to the absence of disqualifying conduct; and

WHEREAS, the Affiant understands that this affidavit will be relied upon by enrollment officials in determining eligibility and that false statements may result in denial, revocation of Global Entry privileges, and criminal or civil penalties as provided by law.

NOW, THEREFORE, the Affiant hereby declares under oath the following statements to be true and accurate:

1. IDENTIFICATION AND BACKGROUND

1.1 Affiant affirms that the identifying information provided in the application and above is true, complete and correct to the best of Affiant's knowledge, including full legal name, date of birth, nationality, and government-issued identification numbers.

1.2 Known Aliases: . If none, write "None".

2. AUTHORIZATION AND CONSENT

2.1 Affiant expressly authorizes authorized representatives of the Trusted Traveler Program, law enforcement, immigration, customs, and national security agencies to conduct such criminal history, immigration status, and identity verification checks as deemed necessary for evaluation of the Global Entry application and continued enrollment.

2.2 Affiant consents to the collection, retention and use of biometric identifiers, including fingerprints and facial images, and authorizes the disclosure of biographic and biometric information to other governmental agencies for security vetting and identity resolution.

2.3 Consent to Information Sharing: I consent to the foregoing authorizations and information sharing.

3. CRIMINAL HISTORY AND IMMIGRATION STATUS

3.1 Affiant affirms that, except as disclosed below, Affiant has not been convicted of any felony or of any offense involving moral turpitude, nor has Affiant been convicted of an offense for which sentence was imposed within the period specified by program rules.

3.2 Have you ever been arrested, charged, or convicted for any criminal offense (including traffic offenses other than minor vehicle infractions)?   Yes   No

4. ATTESTATION AND OATH

4.1 I, the Affiant, do solemnly swear or affirm under penalty of perjury under the laws of the applicable jurisdiction that the statements made in this Affidavit are true and correct. I understand that knowingly providing false information may subject me to criminal prosecution, fines, and denial or revocation of enrollment in the Global Entry program.

4.2 I agree to notify program authorities of any changes to information provided herein, including but not limited to legal name changes, citizenship, criminal charges or convictions, and changes of address.

5. REPRESENTATIONS AND WARRANTIES

5.1 Affiant represents and warrants that Affiant is eligible to make this affidavit and that execution of this affidavit does not violate any court order, immigration condition, or other legal restriction applicable to Affiant.

5.2 Affiant further warrants that Affiant has read and understands the program rules and acknowledges that enrollment may be denied or revoked for misrepresentation or failure to comply with conditions of enrollment.

6. NOTICES

Any notices required by this affidavit shall be delivered to the addresses below by certified mail, personal delivery, or other method providing written receipt.

7. MISCELLANEOUS PROVISIONS

Governing Law: This affidavit shall be governed by and construed in accordance with the laws of the state identified in the introductory heading and applicable federal law, without regard to conflict of law principles.

Entire Agreement: This affidavit, together with any application materials, constitutes the entire understanding between the Affiant and the program with respect to the matters herein and supersedes all prior statements, understandings, or agreements, whether oral or written.

Severability: If any provision of this affidavit is determined to be invalid or unenforceable, the remainder of the affidavit shall remain in full force and effect.

Amendments and Waiver: No amendment or waiver of any provision of this affidavit shall be effective unless in writing and signed by the party to be charged. The failure to exercise any right under this affidavit shall not constitute a waiver of that right.

ACKNOWLEDGMENT

I declare under penalty of perjury that the foregoing is true and correct. Executed on this date below.

Sign Now