3/13/2020 Official Trusted Traveler Program Website | Department of Homeland Security

U.S. Customs and

Border Protection

Official Trusted Traveler Program Website | Department of Homeland Security

Application for: Global Entry Renewal

Version: Draft

Time of Printout: 2020-03-13 12:55 PM Eastern Daylight Time

 Print

 Note: You cannot make changes to an application once it is submitted. If you find errors, the Officer at the enrollment center will need
to change your application for you.

 Please review each section, confirm your answers are correct, and then click Save & Continue to certify and pay.

 1 Personal Info

Your Profile Info

Surname/last name: Warner

Given/first name: Joshua
Middle name:

Date of Birth:
Birth Feb 27, 1992
City of birth: Tampa
Country of birth: UNITED STATES
State/province of birth: FLORIDA

E-mail address: joshua.a.warner@outlook.com

Phone number 1:Mobile
1: 1-5736471793

Identifying Characteristics

Gender: Male
Gender
Eye color:
color Bluish Green
Height: 5 ft 11 in
Height

Have you used any other names before?:

before? No

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 2 Documents

Your Citizenship

 UNITED STATES

You've entered 1 document proving you're a citizen of UNITED STATES

Passport (UNITED STATES)

Surname/last name:
name WARNER
Given name:
name JOSHUA ANTHONY
Middle name:
name
Date of birth:
birth Feb 27, 1992

Country of issuance:
issuance UNITED STATES
Passport number:
number 477581182
Date of issue (issuance date):
date) Mar 21, 2011
Date of expiry (expiration date) Mar 20, 2021

You've entered 1 document proving you may enter the United States.

Passport (UNITED STATES)

Surname/last name:
name WARNER
Given name:
name JOSHUA ANTHONY
Middle name:
name
Date of birth:
birth Feb 27, 1992

Country of issuance:
issuance UNITED STATES
Passport number:
number 477581182
Date of issue (issuance date):
date) Mar 21, 2011
Date of expiry (expiration date) Mar 20, 2021

 3 Driver's License
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Driver's License

Do you currently hold a valid driver's license? Yes

Driver's license number: 31819718
Country of issuance: UNITED STATES
State/province of issuance: PENNSYLVANIA
Expiration date: Feb 27, 2022

Is this an enhanced driver's license (EDL)? No

Is this a commercial driver's license (CDL)? No

Surname/last name: Warner

Given/first name: Joshua
Middle name:
Date of Birth:
Birth Feb 02, 1992

 4 Vehicle Info

You have not added a vehicle as part of your application.

 5 Address Info

You have provided the following addresses to meet the address history requirement:

Previous address:
address: Jan 2015-Dec 2018

Country: UNITED STATES

Country

Start date:
date Jan 2015
End date:
date Dec 2018
Address line 1:
1 109 E 4TH AVE 6
Address line 2:
2
City: CONSHOHOCKEN
City
State/province/region: PENNSYLVANIA
State/province/region

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Zip code/postal code:
code 194281980

Current address:
address: Jan 2019-Present
2019-Present

Country: UNITED STATES

Country

Start date:
date Jan 2019
Address line 1:
1 206 SUNSET LN
Address line 2:
2
City: LINCOLN UNIVERSITY
City
State/province/region: PENNSYLVANIA
State/province/region
Zip code/postal code:
code 193529001

 6 Employment Info

You have provided the following employments to meet the employment history requirement:

Previous Employment

Employment Status:
Status Employed
What is your occupation?:
occupation? Outside Sales Rep
When did it begin?:
begin? Sep 2014
When did it end?:
end? Jan 2018
Who is your employer?:
employer? MSC Industrial Supply Co.

What is your employer's phone number?

Phone number format:
format United States, Canada, +1
Phone number:
number 8006457270
Extension:
Extension

Where do you work?

Country: UNITED STATES
Country
Address line 1:
1 75 MAXESS RD
Address line 2:
2
City: MELVILLE
City
State/province/region: NEW YORK
State/province/region
Zip code/postal code:
code 117473151

Previous Employment

Employment Status:
Status Employed

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What is your occupation?:
occupation? Meat and Seafood Department
When did it begin?:
begin? Jul 2014
When did it end?:
end? Sep 2014
Who is your employer?:
employer? Acme Markets

What is your employer's phone number?

Phone number format:
format United States, Canada, +1
Phone number:
number 6102683898
Extension:
Extension

Where do you work?

Country: UNITED STATES
Country
Address line 1:
1 851 Gap Newport Pike
Address line 2:
2
City: Avondale
City
State/province/region: PENNSYLVANIA
State/province/region
Zip code/postal code:
code 19311

Previous Employment

Employment Status:
Status Employed
What is your occupation?:
occupation? Retail Sales
When did it begin?:
begin? May 2014
When did it end?:
end? Aug 2014
Who is your employer?:
employer? Radioshack

What is your employer's phone number?

Phone number format:
format United States, Canada, +1
Phone number:
number 5733646440
Extension:
Extension

Where do you work?

Country: UNITED STATES
Country
Address line 1:
1 1308 Forum Drive
Address line 2:
2
City: Rolla
City
State/province/region: MISSOURI
State/province/region
Zip code/postal code:
code 65401

Previous Employment

Employment Status:
Status Employed
What is your occupation?:
occupation? Delivery Driver
When did it begin?:
begin? Mar 2014
When did it end?:
end? May 2014
Who is your employer?:
employer? Jimmy Johns

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What is your employer's phone number?
Phone number format:
format United States, Canada, +1
Phone number:
number 5733419009
Extension:
Extension

Where do you work?

Country: UNITED STATES
Country
Address line 1:
1 1051 North Bishop Avenue
Address line 2:
2
City: Rolla
City
State/province/region: MISSOURI
State/province/region
Zip code/postal code:
code 65401

Previous Employment

Employment Status:
Status Employed
What is your occupation?:
occupation? Home Chef
When did it begin?:
begin? Aug 2013
When did it end?:
end? May 2014
Who is your employer?:
employer? Theta Xi Fraternity

What is your employer's phone number?

Phone number format:
format United States, Canada, +1
Phone number:
number 5733646294
Extension:
Extension

Where do you work?

Country: UNITED STATES
Country
Address line 1:
1 1605 North Pine Street
Address line 2:
2
City: Rolla
City
State/province/region: MISSOURI
State/province/region
Zip code/postal code:
code 65401

Previous Employment

Employment Status:
Status Employed
What is your occupation?:
occupation? Skilled Maintenance
When did it begin?:
begin? May 2013
When did it end?:
end? Aug 2013
Who is your employer?:
employer? Missouri University of Science and Technology

What is your employer's phone number?

Phone number format:
format United States, Canada, +1
Phone number:
number 5733414111
Extension:
Extension

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Where do you work?
Country: UNITED STATES
Country
Address line 1:
1 205 West 12th Street
Address line 2:
2
City: Rolla
City
State/province/region: PENNSYLVANIA
State/province/region
Zip code/postal code:
code 65401

Previous Employment

 7 Travel History

Countries Visited

Have you traveled to countries other than the United States, Canada, and Mexico since March 2015?
Yes

Countries:

IRELAND
ITALY
GREECE
FRANCE
HONDURAS
BELIZE

 8 Additional Info

Background Questions

Have you ever been convicted of a criminal offense in the United States or any other country?

No

Have you ever been arrested or had charges that were expunged or removed? If yes please describe.

Have you ever received a waiver of inadmissibility to the U.S. from a U.S. government agency?

No

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Have you ever been found in violation of customs laws?

No

Have you ever been found in violation of immigration laws?

No

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