IX. Fill in the U. S. Customs Declaration form
WELCOME to the UNITED STATES
CUSTOMS DECLARATION
Each arriving traveler head of family must provide the following information (only ONE declaration per family is required)
1. Name: _________________________________________________
Last First Middle
2. Date of birth: _______________ 3. Airline/Flight ______________
4. Number of family members traveling with you_________________
5. U.S. Address: ___________________________________________
City: ____________________ State: ___________________________
6. I am a US. Citizen Yes No
If No. Country ____________________________________________
7.I reside permanently Yes No
If No. Expected length of stay: _______________________________
8. The purpose of my trip is: Business Pleasure
9. I am/ we are bringing fruits, plants, meats, food, soil, birds, snails, other live animals, farm products, or I/ we have been on a farm or ranch outside the USA Yes No
10. I am/ we are carrying currency or monetary instruments over
$ 10, 000 U.S. or foreign equivalent. Yes No
11. The total value of goods I/ we purchased or acquired abroad and am/ are bringing to the U.S. is (see instructions under Merchandise on reverse side): $ _________________
U.S. Dollars
MOST MAJOR CREDIT CARDS ACCEPTED
_________________________________________________________
SIGN ON REVERSE SIDE AFTER YOU HAVE READ THE WARNING.
_________________________________________________________
(Don’t write below this line)
_________________________________________________________
Inspector’s name Stamp area
X.People often do these things when they travel. Match the words from columns A and B to make the correct phrases.
A B
apply security
buy for a visa
confirm tickets
collect at the check in
go through one’s flight
line one’s baggage
watch a hotel room
book an in- flight movie
travel to the station
check in a bus or taxi
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