Declaration Card
– For Agency Use Only –
PAX
R
U.S. V
OV
Cr
O
Part A
All travellers (living at the same address) – Please print in capital letters.
Instructions
Last name, first name and initials
All travellers must be identified on a
1
Canada Border Services Agency (CBSA)
Citizenship:
Date of birth:
Declaration Card. You may list up to four
Y
Y
M
M
D
D
people living at the same address on one
Last name, first name and initials
card. Each traveller is responsible for
his or her own declaration.
2
Citizenship:
Under the law, failure to properly declare
Date of birth:
Y
Y
M
M
D
D
goods, currency and/or monetary
Last name, first name and initials
instruments brought into Canada may
result in seizure action, monetary penalties
3
and/or criminal prosecution.
Citizenship:
Date of birth:
Y
Y
M
M
D
D
Information from this declaration will be
Last name, first name and initials
used for CBSA control purposes, and
may be shared with other government
4
departments to enforce Canadian laws.
For more information see Info Source
Citizenship:
Date of birth:
Y
Y
M
M
D
D
(ref. no. CBSA PPU 018), at a public
library or visit
HOME ADDRESS – Number, street, apartment No.
City/Town
Part B – Visitors to Canada
Prov./State
Country
Postal/Zip code
The following duty-free allowances apply
to each visitor entering into Canada:
Arriving by:
Purpose of
Arriving from:
Gifts (excludes alcohol and tobacco)
Study
Air
Rail
Marine
Highway
U.S. only
valued at no more than CAN$60 each.
Airline/flight No., train No. or vessel name
Personal
Other country direct
1.5 L of wine or 1.14 L of liquor or
Business
Other country via U.S.
24 x 355 ml cans or bottles (8.5 L) of
I am/we are bringing into Canada:
Yes
No
– For Agency Use Only –
beer or ale.
•
Firearms or other weapons
(e.g. switchblades, Mace or pepper spray).
200 cigarettes, 200 tobacco sticks,
50 cigars or cigarillos and
•
Commercial goods, whether or not for resale
(e.g. samples, tools, equipment).
200 grams of manufactured tobacco.
•
Meat/meat products; dairy products; fruits;
vegetables; seeds; nuts; plants and animals or their
Part C – Residents of Canada
parts/products; cut flowers; soil; wood/wood
products; birds; insects.
Each resident returning to Canada is
• Currency and/or monetary instruments of a value
entitled to one of the following personal
totalling CAN$10,000 or more per person.
exemptions based on his/her time absent
I/we have shipped goods that are not accompanying
from Canada (include all goods and/or
me/us.
gifts purchased or received abroad):
I/we have visited a farm and will be going to a farm in
24 hours: CAN$50
Canada.
Not claimable if goods exceed $50.
Part B Visitors to Canada
Alcohol and tobacco cannot be claimed.
Yes
No
Duration of stay in Canada
48 hours: CAN$400
Do you or any person listed above exceed the duty-free
days
allowances per person? (See instructions on the left.)
This includes alcohol and tobacco
(see table below)
.
Part C
Residents of Canada
7 days:
CAN$750
Yes
No
Do you or any person listed above exceed the exemptions per person?
This includes alcohol and tobacco
(See instructions on the left.)
(see table below)
.
Complete in the same order as Part A
Alcohol and tobacco
Value of goods – CAN$
Value of goods – CAN$
Value of goods – CAN$
exemption table
Date left Canada
Date left Canada
purchased or received abroad
purchased or received abroad
purchased or received abroad
YY - MM - DD
YY - MM - DD
(including gifts, alcohol & tobacco)
(including gifts, alcohol & tobacco)
(including gifts, alcohol & tobacco)
1.5 L of wine or 1.14 L of liquor or
24 x 355 ml cans or bottles (8.5 L) of
1
3
Y
Y
M
M
D
D
Y
Y
M
M
D
D
beer or ale. (You must be of legal age
2
4
Y
Y
M
M
D
D
Y
Y
M
M
D
D
in the province of importation.)
Signatures (age 16 and older): I certify that my declaration is true and complete.
Part D
200 cigarettes, 200 tobacco sticks,
50 cigars or cigarillos and
1
Date
Y
Y
M
M
D
D
200 grams of manufactured tobacco
2
(Special Duty may apply).
3
4
E311 (08/04)
Protected A when completed
BSF311
Do not fold Declaration Card
A580G1.FRP
(08/04)