Sample U.s. Customs Declaration Form (Page 2 of 2) in pdf

U.S. Customs and Border Protection

Welcomes You to the United States

U.S. Customs and Border Protection is responsible for protecdng the United

States against the illegal importation of prohibited items. CBP officers have the

authority to question you and to examine you and your personal properry. If

you are one ofthe travelers selected for an examinarion, you will be treated in a

courteous, professional, and dignified manner. CBP Supervisors and Passenger

Service Representatives are available to answer your questions. Comment cards

are available to compliment or provide feedback.

lmpoitant Information

U.S. Residents -

declare all articles tiat you have acquired abroad and are

bringing into the United States.

Visitors (Non-Residents)

declare the value of all articles that will remain

in the United States.

Declare all articles on this declaration form and show the value in U.S. dollars.

For gifis, please indicate the retail value.

D.tty -

CBP officers will determine duty. U.S. residents are normally entitled

to a duty-free exemption of $800 on items accompanying them. Visitors (non-

residents) are normally entided to an exemption of $100. Dury witl be assessed

at the current rate on the first $1,000 above the exemption.

Controlled

substances, obscene articles, and toxic substances are

generally prohibited

entfy. Agriculture

products are reefficted entry.

Thank You, anil Vlhlccme to tbe IJniteil Statet.

The transportation of currency or monetary instruments, regardless of the

amount, is legal. However, if you bring in to or take out of tle United States

more than $10,000 (U.S. or foreign equivalent, or a combination of both), you are

required by law to file a report on FinCEN 105 (formerly Customs Form 4790)

with U.S. Customs and Border Protection. Monetary instruments include coin.

currency, travelers check and bearer instruments such as personal or cashiers checks

and stocks and bonds. If you have someone else carry the currency or monetary

instrument for vou. vou must also file a reDort on FinCEN 105. Faiiure to file th!

requ.ired report or ir'il*" to report the tut;l amotrrft that you.are carrying may lead

to ttre seizure of all the currency or monetary instruments, and may subject you to

civil penalties and/or criminal prosecution. SIGN ON THE OPPOSffE SIDE OF

THIS FORA4 AFTER YOU TIA\,'E READ THE IIVTPORTI{NT INFOR.N,IAIION

ABOVE AND MADE A TRUTHFI]L

DECLAMTION.

Description of Articles

(List may contlnue on another CBP Form 60598)

ValUe

Total

PAPERWORK

REDUCTION

ACf NOTICE: Th6 Paperuod( Reduclion Acl says w must tell you why we are mllecting thls intomation,

t|o\ir lve will use it, and wheths you have to giv€ il to us. The information collecied on this fom is needed to c€rry out the Customs,

Agticulhire, ad urency laws of the Unihd Stales. CBP requires the infornation on lfiis form to in6ure that travelers are mmplying

wih t€s hs and io allow us to figure and mllect lhe fight amount of duty and tax. Your response is mandatory- An agencl may not

$rduct s sponw, and a poFon is rct requiFd to 6pond to a coll€clion of infomation, unless it displays a valid oMB 6ntml number

The estimaH avemge burdon a$miated with lhis mllecton of infomation is 4 minutes per respondent or recod keeper depending on

individul cirdmstances. Comm€nts conceming the amumcy of $is burden estimate and suggesllons for rcducing this burden should

be directed to U.S. Custons and Bordsr Prdtection, Repons Clearanm offmr, lnfomation Seryices Branch, Washing'ton,

20229, and to the Offce ofManagemont and Budget, PapeMo* Reducdon Project (1651.0009), Washington, DC 20503. THIS FORM

I{AY NOT gE REPRODUCED

WTHOUT APPROVAT FROI,I THE CBP FORMS MAI'IAGER

'u.S. G.Po.:2005 - 783-076/80026

CBP Form 60598 (01/04)

CBP

tlse Only

SAMPLE

Sample U.s. Customs Declaration Form Page 2

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