Form E311 - Declaration Card (Specimen)
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1Declaration Card
Canada Border
Agence des services
Services Agency
frontaliers du Canada
– For Agency Use Only –
PAX
R
U.S. V
OV
Cr
O
Instructions
Part A
All travellers (living at the same address) – Please print in capital letters.
All travellers can be identified on a Canada
Last name, first name and initials
Border Services Agency (CBSA) Declaration
Card. You may list up to four people living at the
1
same address on one card. Each traveller is
Date of birth:
responsible for his or her own declaration.
Citizenship:
Y
Y
M
M
D
D
YY - MM - DD
Each traveller is responsible for reporting
Last name, first name and initials
currency and/or monetary instruments
totaling CAN$10,000 or more that are in his
2
or her actual possession or baggage.
Date of birth:
Citizenship:
Y
Y
M
M
D
D
Under the law, failure to properly declare goods,
YY - MM - DD
currency and/or monetary instruments brought
Last name, first name and initials
into Canada may result in seizure action,
monetary penalties and/or criminal prosecution.
3
Date of birth:
Citizenship:
Y
Y
M
M
D
D
Information provided is collected under the
YY - MM - DD
authority of Section 12 of the Customs Act
Last name, first name and initials
to facilitate compliance with the traveller’s
obligation with Subsection 5(3), Reporting of
4
Imported Goods Regulations, and enables
Date of birth:
Citizenship:
Y
Y
M
M
D
D
the collection of duty and taxes payable on
YY - MM - DD
imported goods. This information may be
HOME ADDRESS – Number, street, apartment No.
City/Town
disclosed to other government departments and
agencies, police forces and other Countries to
administer or enforce Canadian Legislation.
Prov./State
Country
Postal/Zip code
Individuals have the right of access to and/or
can make corrections of their personal
Arriving by:
Purpose of trip:
Arriving from:
information under the Privacy Act. The
Study
Air
Rail
Marine
Highway
U.S. only
information is described within Info Source,
Traveller Declaration Cards Personal
Airline/flight No., train No. or vessel name
Personal
Other country direct
information Bank CBSA PPU 018 at
Business
Other country via U.S.
I am/we are bringing into Canada:
Yes
No
Part B – Visitors to Canada
Firearms or other weapons
(e.g. switchblades, Mace or pepper spray).
The following duty-free allowances apply to
Commercial goods, whether or not for resale
each visitor entering into Canada:
(e.g. samples, tools, equipment).
Gifts (excludes alcohol and tobacco)
Meat, fish, seafood, eggs, dairy products, fruits,
valued at no more than CAN$60 each.
vegetables, seeds, nuts, plants, flowers, wood,
*
Alcohol and tobacco (see table below
).
animals, birds, insects, and any parts, products or
by-products of any of the foregoing.
Part C – Residents of Canada
Currency and/or monetary instruments totaling
CAN$10,000 or more.
Each resident returning to Canada is
entitled to one of the following personal
I/we have unaccompanied goods.
exemptions (include all goods and/or gifts
purchased or received abroad):
I/we have visited a farm and will be going to a farm in
Canada.
24 hours absence from Canada: CAN$200
Not claimable if goods exceed CAN$200.
Part B Visitors to Canada
Alcohol, tobacco and unaccompanied goods
Yes
No
Duration of stay in Canada
cannot be claimed.
Do you or any person listed above exceed the duty-free
days
allowances per person? (See instructions on the left.)
48 hours absence from Canada: CAN$800
This includes alcohol and tobacco (see table
Part C
Residents of Canada
*
below
). Unaccompanied goods cannot be
Yes
No
Do you or any person listed above exceed the exemptions per person?
claimed.
(See instructions on the left.)
7 days absence from Canada: CAN$800
Complete in the same order as Part A
This includes alcohol, tobacco (see table
*
below
) and unaccompanied goods.
Value of goods – CAN$
Value of goods – CAN$
Date left Canada
Date left Canada
purchased or received abroad
purchased or received abroad
YY - MM - DD
YY - MM - DD
*
Alcohol and tobacco table
(including gifts, alcohol & tobacco)
(including gifts, alcohol & tobacco)
1
1
3
3
Y
Y
M
M
D
D
Y
Y
M
M
D
D
1.5 L of wine or 1.14 L of liquor or 24 x
2
4
355 ml cans or bottles (8.5 L) of beer or
Y
Y
M
M
D
D
Y
Y
M
M
D
D
ale. (You must be of legal age in the
Signatures (age 16 and older): I certify that my declaration is true and complete.
Part D
province of importation.)
1
1
Date
200 cigarettes, 200 tobacco sticks, 50
Y
Y
M
M
D
D
2
2
YY - MM - DD
cigars or cigarillos and 200 grams of
manufactured tobacco (Special Duty
3
3
4
4
may apply).
E311 (16)
B
Protected A when completed
Do not fold Declaration Card
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