Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694499983204.pdf (Antigua and Barbuda)
FORM 1 - Section 18(1) of the Money Laundering (Prevention) Act 1996 Report of International Transfer of Currency Valued $ 1 0, 000 U.S. or more Complete this form and give to a CUSTOMS OFFICER at an ANTIGUA AND BARBUDA PORT/AIRPORT/POINT of arrival or departure CUSTOMS USE ONLY Veriﬁed (name, DOB, Passport) Yes Verﬁed currency Yes No No Ofﬁcer Port Customs Report No.

Date SUPERVISORY AUTHORITY USE ONLY ONDCP Report No.
ONDCP Case Ofﬁcer Transferring cash or negotiable ﬁnancial instruments into or out of Antigua and Barbuda This form should be completed by the following: (a) any person who has made a Customs Declaration of carrying currency of a value in excess of $10,000 United States Dollars.

(b) any person who transfers or carries Eastern Carib- bean and/or other currency in cash or negotiable ﬁ- nancial instruments which amounts to $10,000 U.S. or more or the equivalent in other currency.
Cash means the coin and paper money of any cur- rency.

Bearer negotiable instruments include travellers cheques and other monetary instruments.

Reporting of transfers of cash or bearer negotiable ﬁnancial instruments valued at $10,000 U.S. or more, or equivalent in other currency into or out of Antigua and Barbuda is required by law under Section 18 of the Money Laundering (Prevention) Act 1996 as amended.

Antigua and Barbuda has a dual reporting system.


Ev- ery traveller entering the country must make a Customs Declaration.

If in your Customs declaration you have declared being in possession of currency valued in ex- cess of US$10,000, then you are required also to com- plete this form with additional information.

Every traveller leaving Antigua and Barbuda in posses- sion of currency valued at US$10,000 or more is re- quired to complete this form whether or not he has ﬁlled out a Customs Declaration.
The Money Laundering (Prevention) Act 1996 The Money Laundering (Prevention) Act [No.

9 of 1996] as amended assists in the detection of serious criminal activity, including money laundering from drug trafﬁcking and organised crime.

Penalties There are penalties for failure to make a report to a customs ofﬁcer assigned for duty at the point of arrival or departure or supply full and correct information.
The penalties include: • imprisonment for a period not more than two years; and/or • a ﬁne of up to ﬁfty thousand dollars; and • the conﬁscation of the cash or negotiable instruments being transported.

Further information or assistance The ofﬁce of the Supervisory Authority is at the Head- quarters of the Ofﬁce of National Drug and Money Laundering Control Policy (ONDCP).

Staff of the ONDCP Financial Intelligence Unit can as- sist with any inquiries.
Telephone (268) 562-3265 or (268) 562-3255 Continued overleaf 9 June 2010 FORM 1 - Section 18(1) of the Money Laundering (Prevention) Act 1996 COMPLETE ENTIRE FORM 12.

Where is the currency being imported from or taken to?

Part A Currency arriving or leaving 1.


I am carrying or transferring currency valued at $10,000 or more United States Dollars: City/Town Country into Antigua and Barbuda out of Antigua and Barbuda Part B Detail of the person carrying or transferring the currency into or out of Antigua and Barbuda 13.

Are you traveling in a group?

Yes No 14.

Is any member of the group transporting currency on your behalf not accounted for in item 11 above?

Yes No 15.
Yes No 15.

If the answer to 14 is yes, give the persons’ name 2.

First name Middle name Surname 3.

Date of Birth 16.

How much currency is the person carrying?

17.

I am carrying or transferring the currency: wholly or partly on behalf of another person, business or organization Go to Part D; day month year 4.

Permanent address in home country wholly on my own behalf Go straight to Part E City State Post code Country 5.

Are you resident in Antigua and Barbuda?

Yes No 6.
Yes No 6.

Address while in Antigua and Barbuda Street City/Village 7.

Occupation or business activity 8.

Passport details: (a) Number of passports held by you (b) 9.

Port of arrival or departure 10.

Date or arrival or departure day month year Part C Details of currency being car- ried or transfered Part D (a) Details of the person, busi- ness or organizaton from whom the currency was obtained 18.

Name of organization or Name of person First name Middle name Surname 19.
Address of person or organization City State Post code Country 20.

Occupation or business activity (b) Details of the person, business or organizaton to whom the currency is being transferred 21.

Name of organization or Name of person First name Middle name Surname 22.

Address of person or organization City State Post code Country 23.

Occupation or business activity Part E Declaration and signature I declare the above information to be correct.

Date: dd-mmm-yyyy Signature