Do you have a physical or mental disorder; or are you a drug abuser or addict; or do you currently have any of the following diseases (communicable diseases are specified pursuant to section 361(b) of the Public Health Service Act):

• Cholera
• Difteria
• Infectious tuberculosis
• Plague
• Smallpox2
• Yellow fever Viral Hemorrhagic Fevers, including Ebola, Lassa, Marburg virus disease, Crimean-Congo
• Severe acute respiratory illnesses capable of transmission to other persons and likely to cause mortality

Have you ever been arrested or convicted for a crime that resulted in serious damage to property, or serious harm to another person or government authority?

Have you ever violated any law related to possessing, using, or distributing illegal drugs?

Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide?

Have you ever committed fraud or misrepresented yourself or others to obtain, or assist others to obtain, a visa or entry into the United States?

Are you currently seeking employment in Indonesia, or were you previously employed in Indonesia without prior permission from the Indonesian government?

Have you ever been denied an Indonesian visa with your current or previous passport, or have you ever been refused admission to Indonesia or withdrawn your application for admission at an Indonesian port of entry?

Have you ever exceeded the granted admission period during your stay in Indonesia, as provided by the Indonesian government?

Have you traveled to, or been present in Iraq, or after March 1, 2019?