This Space For Official Use Only

U.S. Customs and Border Protection Welcomes You to the United States

FORM APPROVEDOMB NO.1651-0009
19 CFR 122.27, 148.12, 148.13, 148.110, 148.111, 19 USC 1498; 31 CFR 5316

Customs Declaration

Each arriving traveler or responsible family member must provide thefollowing information (only ONE written declaration per family is required).
The term "family" is defined as "members of a family residing in the same
household who are related by blood, marriage, domestic relationship, oradoption."
1 Family NameMiddle

First (Given)
2 Birth dateMonthDay

Year

3 Number of Family members traveling with you
4 (a) U.S. Street Address (hotel name/destination)(b) City(c) State

5 Passport issued by (country)
6 Passport number
7 Country of Residence
8 Countries visited on thistrip prior to U.S. arrival
9 Airline/Flight No. or Vessel Name
10 The primary purpose of this trip is business:

Yes

No

(a) fruits, vegetables, plants, seeds, food, insects:

Yes

No(b) meats, animals, animal/wildlife products:

Yes

No

(c) disease agents, cell cultures, snails:

YesNo(d) soil or have been on a farm/ranch/pasture:

Yes

No

12 I have (We have) been in close proximity of livestock: Yes

No

11 I am (We are) bringing(such as touching or handling)
13 I am (We are) carrying currency or monetary instruments
over $10,000 U.S. or foreign equivalent:

Yes

NoYes

No

(see definition of monetary instruments on reverse)
14 I have (We have) commercial merchandise:

U.S. Customs and Border Protection is responsible for protecting theUnited States against the illegal importation of prohibited items. CBP
officers have the authority to question you and to examine you and yourpersonal property. If you are one of the travelers selected for an
examination, you will be treated in a courteous, professional, anddignified manner. CBP Supervisors and Passenger Service
Representatives are available to answer your questions. Comment cards
are available to compliment or provide feedback.
Important Information
U.S. Residents—Declare all articles that you have acquired abroad andare bringing into the United States.
Visitors (Non-Residents)—Declare the value of all articles that willremain in the United States.
Declare all articles on this declaration form and show the value in U.S.
dollars. For gifts, please indicate the retail value.
Duty—CBP officers will determine duty. U.S. residents are normallyentitled to a duty-free exemption of $800 on items accompanying
them. Visitors (non-residents) are normally entitled to an exemptionof $100. Duty will be assessed at the current rate on the first $1,000
above the exemption.
Agricultural and Wildlife Products—To prevent the entry of dangerous
agricultural pests and prohibited wildlife, the following are restricted:
Fruits, vegetables, plants, plant products, soil, meat, meat products,birds, snails, and other live animals or animal products. Failure todeclare such items to a Customs and Border Protection Officer/Customs and Border Protection Agriculture Specialist/Fish andWildlife Inspector can result in penalties and the items may besubject to seizure.
Controlled substances, obscene articles, and toxic substances aregenerally prohibited entry. The importation of merchandise into theU.S. that infringes intellectual property rights may subject travelers tocivil or criminal penalties and may pose serious risk to safety or health.
The transportation of currency or monetary instruments, regardless of
the amount, is legal. However, if you bring into or take out of the UnitedStates more than $10,000 (U.S. or foreign equivalent, or a combinationof both), you are required by law to file a report on FinCEN 105 (formerlyCustoms Form 4790) with U.S. Customs and Border Protection.
Monetary instruments include coin, currency, travelers checks andbearer instruments such as personal or cashiers checks and stocks andbonds. If you have someone else carry the currency or monetary
instrument for you, you must also file a report on FinCEN 105. Failure tofile the required report or failure to report the total amount that you arecarrying may lead to the seizure of all the currency or monetary
instruments, and may subject you to civil penalties and/or criminal
prosecution. SIGN ON THE OPPOSITE SIDE OF THIS FORM AFTERYOU HAVE READ THE IMPORTANT INFORMATION ABOVE AND
MADE A TRUTHFUL DECLARATION.
Description of Articles(List may continue on another CBP Form 6059B)

Value

CBPUse Only

(articles for sale, samples used for soliciting orders,or goods that are not considered personal effects)

15 RESIDENTS—the total value of all goods, including commercial
merchandise I/we have purchased or acquired abroad, (including
gifts for someone else but not items mailed to$
the U.S.) and am/are bringing to the U.S. is:
VISITORS—the total value of all articles that$will remain in the U.S., including commercial
merchandise is:
Read the instructions on the back of this form. Space is provided to list
all the items you must declare.
I HAVE READ THE IMPORTANT INFORMATION ON THE REVERSE SIDE OF THIS FORM
AND HAVE MADE A TRUTHFUL DECLARATION.

X
Signature

Date (month/day/year)

CBP Form 6059B (7/24)

Total
PAPERWORK REDUCTION ACT STATEMENT: An agency may not conduct orsponsor an information collection and a person is not required to respond to thisinformation unless it displays a current valid OMB control number. The control
number for this collection is 1651-0009. The estimated average time to complete
this application is 4 minutes. Your response is mandatory. If you have any
comments regarding the burden estimate you can write to U.S. Customs andBorder Protection Office of Regulations and Rulings, 90 K Street, NE, 10th Floor,
Washington, DC 20229.

CBP Form 6059B (7/24