Personal Effects Accounting Document (Settler, Former Resident, Seasonal Resident, Or Beneficiary)
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1
2Agence des douanes
Canada Customs
PROTECTED (when completed)
and Revenue Agency
et du revenu du Canada
PERSONAL EFFECTS ACCOUNTING DOCUMENT
Accounting Document No.
(Settler, Former Resident, Seasonal Resident, or Beneficiary)
Shaded areas for
customs use only
Importer’s Name
Cargo Control No.
Customs Stamp
Country of Origin
Country of Export
Importer’s Address
Landed Immigrant / Permanent Resident
Port of Entry
Date of Landing
IMM 1000 No.
Item
Description of Goods (include serial numbers, if applicable)
Value (CDN Dollars)
1
2
3
4
5
6
7
8
All conveyances MUST be eligible for importation in accordance with Transport Canada requirements.
Vehicle import registration fees may also apply.
Value (CDN Dollars)
K22 / Vehicle Import Form No.
Conveyances (make, model, serial number of vehicle, vessel, aircraft, or trailer)
1
2
3
Form B15 No. (if applicable)
Mover’s
No
Additional List of Goods
Form B4A
Other
Goods to Follow
Yes
Inventory
CLASSIFICATION TYPE – See information on reverse
FORMER RESIDENT (tariff item No. 9805.00.00)
BENEFICIARY (tariff item No. 9806.00.00)
I hereby declare that I have read and qualify for the provisions of tariff item
I hereby declare that I have read and qualify for the provisions of tariff item
No. 9806.00.00 and that I am a beneficiary of personal and household effects which
No. 9805.00.00 and that:
were bequeathed to me without remuneration as:
1.
I have been a resident of another country for at least one year; or
1.
The result of the death of
,
2.
I have been continuously absent from Canada for at least one year; and
a resident of
,
3.
I left Canada on _____________________ ; and
who died on
; or
4.
I returned to Canada to resume residence on _______________________ .
In anticipation of the death of
,
5.
With the exception of wedding gifts, bride’s trousseau, alcoholic beverages
who resides in
.
and tobacco products or replacement goods described in the Tariff Item
No. 9805.00.00 Exemption Order , all household and personal effects
imported or to be imported by me under this tariff item have been actually
I have attached:
owned, possessed, and used abroad by me for at least six months prior to
the date of my return to Canada to resume residence.
1.
A copy of the will, showing that I am a beneficiary of the estate;
6.
All goods imported are my personal or household effects and were not used
2.
A signed statement from the donor outlining the circumstances of the gift; or
abroad for any commercial purpose nor will they be used in Canada for any
3.
A statement from the executor of the estate or other legal reprresentative of
commercial purpose.
the donor outlining the circumstances of the gift.
7.
If any item is sold or otherwise disposed of in Canada within 12 months of
the date of its importation, I will notify a customs office of such fact and pay
all duties owing at the time.
SEASONAL RESIDENT (tariff item No. 9829.00.00)
SETTLER (tariff item No. 9807.00.00)
I hereby declare that I have read and qualify for the provisions of
I hereby declare that I have read and qualify for the provisions of tariff item
tariff item No. 9829.00.00 and that:
No. 9807.00.00 and that:
1.
I arrived in Canada to occupy my seasonal residence for the first time
1.
I am entering Canada with the intention of establishing, for the first time, a
permanent residence for a period in excess of 12 months and I arrived in
on __________________ .
Canada on __________________ .
2.
All goods imported or to be imported by me under this tariff item have been in my
ownership, possession, and use prior to my first arrival in Canada to occupy my
2.
With the exception of wedding gifts, bride’s trousseau, alcoholic beverages and
seasonal residence.
tobacco products described in the Tariff Item No. 9807.00.00 Exemption Order , all
household and personal effects imported or to be imported by me under this
3.
All goods imported are my personal or household property and they will not be used
tariff item have actually been owned, possessed, and used abroad by me prior to
in Canada for any commercial purpose.
the date of my arrival in Canada.
4.
If any item is sold or otherwise disposed of in Canada within 12 months of the date of
3.
All goods imported are my personal or household property and they will not be used
its importation, I will notify a customs office of such fact and pay all duties owing at
in Canada for any commercial purpose.
the time.
4.
If any item is sold or otherwise disposed of in Canada within 12 months of the
5.
I have not previously claimed the benefits of tariff item No. 9829.00.00.
date of its importation, I will notify a customs office of such fact and pay all duties
owing at the time.
Signed at
on
Signature of Importer
(Ce formulaire existe aussi en français )
B4 E (01)
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