That is the form travelers from Visa-Waiver countries have to fill in during the flight to the US. It does ask for name and home address in triplicate (+ once more for customs).
Also it includes fields for the US address and a declaration that signing the form will waive all legal rights against the INS.
As icing there are yes/no questions asking for:
- transmissible diseases
- drug addictions
- involvement into espionage, sabotage or terrorism
- involvement into Nazi war crimes
- intent to immigrate illegally
- existing lawsuits concerning child custody
- past problems with US immigration
- legal immunity
So what is the point of this? All the informations needed to answer the questions are transmitted in advance by the airline and is additionally stored digitally on the passport- no need to fill in a form in a shaking airplane. Also, nobody would be so stupid to answer "yes" to one of the yes/no question - except a few innocent jokers.
</rant>