OK Board CIT+NAT

Legal Notice

Authority: The American Samoa Annotated Code Section 41.0402 authorizes the collection of the information and/or documents requested herein.

Purpose: To allow collection and recording of information regarding every person leaving or entering American Samoa.

Routine Use: The American Samoa Government - Department of Legal Affairs personnel will use this information to determine every individual's eligibility to enter American Samoa. Additionally, the Attorney General may share this information with other law enforcement agencies or applicable government agency as necessary.

Disclosure: Furnishing the requested information is voluntary, however, failure to furnish the requested information or documents may prevent completion of your application for an entry authorization.
OK BOARD APPLICATION

For U.S. Citizens or U.S. Nationals only.
Personal Information
Full Name *

First Name Middle Name Last Name
Date of Birth *

Month Day Year
Gender *

Male Female
Address
Current Address *

Street Address Line 1

Street Address Line 2

City State

Postal / Zip Code Country
E-mail *

Confirmation Email example@example.com
Phone Number *

Area Code Phone Number
Travel Information
Reason for travel to Am. Samoa *
Date of Arrival *

Month Day Year
Accommodations *

Hotel Family/Friends Returning Resident
Name of Hotel *

Hotel Name

Location

Village State / Province

Postal / Zip Code Country
Phone Number for Hotel *

Area Code Phone Number
If family/friends, list name of local contact *

Name of Local Contact

Relationship

Village State / Province

Postal / Zip Code Country
Phone Number of local family/friend *

Area Code Phone Number
If other, please explain *
Required Documents
Upload Copy of Birth Certificate or applicable document *
Date Passport issued *

Month Day Year
Date
Date Passport expires *

Month Day Year
Date
Please upload a scan of the following documents for submission to the Office of the Attorney General.
1. Copy of Birth Certificate or a Copy of the applicable document
2. Copy of a state issued ID
3. Copy of your ticket or itinerary
Upload files here *

Upload a File

Cancel of
Have you provided copies of the following documents? *
By clicking the submit button below, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if allowed to enter American Samoa, falsified statements on this application shall be grounds to refuse entry into any port of entry in American Samoa, or for immediate removal.

Additionally, by clicking the submit button below, I authorize investigation of all statements, claims, or information contained herein and the reference listed above to give the American Samoa Government any and all information they may have, personal or otherwise, and I hereby release the American Samoa Government from any and all liability for any damage that may result from utilization of such information.

Furthermore, by clicking "Submit" I also agree that the $50 (USD) application fee is non-refundable.

IMPORTANT NOTE

Please take note that submission and acceptance of your application does not constitute automatic approval thereof. Only an affirmative correspondence from our office explicitly indicating approval of your submission is valid. You are required to print out a copy of said approval and present it to a local immigration officer on demand.
U.S. Citizen or National *
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OK Board U.S. Citizen/National $ 50.00

Total $ 0.00
Should be Empty:

OK BOARD APPLICATION

Personal Information

Address

Travel Information

Required Documents