visa in a the
Embassy of P.R. China in ( country ) /
Date of Birth (yyyy-mm-dd) Consulate General of P.R. China in (city)/
Office of the Commissioner ... Employer/Institution
Residential Address in
Current Occupation
China
Highest Academic Degree Academic Field
From yyyy-mm-dd to yyyy-mm-dd,
Arrival and Departure Date
single/two/multiple entry(ies), stay for days
https://www.justice.gov/epstein/files/DataSet%209/EFTA00315765.pdf