Unaccompanied Personal Effects Form
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4UNACCOMPANIED PERSONAL
EFFECTS STATEMENT
• This is a legally binding document and may be used as evidence.
• This statement must be completed in English (block letters),with
all errors and alterations to be initialled.
WARNING
Do not carry drugs. Penalties for drug offences in Australia are severe. A false or misleading statement to an officer of Customs is an offence and may involve
heavy penalties, including forfeiture of any goods concerned.
NOTICE
The Privacy Act 1988 says we must tell you why we are collecting this information, how we will use it and whether you have to give it to us.
This information is required to ensure travellers comply with customs, Biosecurity, Health, Wildlife and Currency laws.
Customs Act 1901
We require this information under the
, the Quarantine Act 1908, the Environment Protection and Biodiversity Conservation Amendment
(Wildlife Protection) Act 2001 and the Financial Transaction Reports Act 1988. The Department of Immigration and Border Protection also needs the
information to calculate the right amount of duties and taxes. Any questions you do not answer will be asked by an officer of Customs or an officer of the
Department of Agriculture. The Department of Immigration and Border Protection and Department of Agriculture are not permitted to disclose this information
or any supplementary information you give, except when authorised or required by law.
Please complete the following details
Given names
Family name
Address and telephone number of intended or actual Australian residential address
Date of birth
Sex
Passport number
Country of issue
Male
Female
Persons covered
Name of spouse
Myself
Spouse
by this statement:
Spouse passport number
Number of children under 18 years of age
How I arrived or intend to arrive in Australia
On (airline flight number or ship name)
At (port or airport)
Date, or estimated date, of arrival
Country of departure
For returning residents only
Other countries visited
Period of absence from Australia
How my personal effects arrived or will arrive
By Mail; or
By Air; or
By Sea (if by air or sea then complete below)
(number of packages)
The
consigned to me have arrived or are due to arrive:
On (airline flight number or ship name)
At (port or airport)
Date, or estimated date, of arrival
Container number
Sea Bill or Air Waybill number
Name of local business handling your personal effects
Clearing your personal effects
You may clear your personal effects or nominate a representative such as a freight forwarder, customs broker, friend
or relative to act on your behalf. If you wish to nominate somebody else, you must fill in the details of your nominee in the space provided below.
Family name
Given names
Address
Phone number
Your nominee will need to produce the following forms of identification when clearing your goods through customs.
Driver’s licence number
Place of issue
Passport number
Country of issue
and
Declaration
I declare that the above particulars are to the best of my knowledge true and correct.
Signature of owner
Date
B534e (JUL15)
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