Form 6059B Customs Declaration

Customs Declaration

FORM APPROVED
OMB NO. 1651-0009

19 CFR 122.27, 148.12, 148.13, 148.110,148.111, 1498; 31 CFR 5316

Each arriving traveler or responsible family member must provide the ­following
information (only ONE written declaration per family is required):
1. Family Name

Middle

First (Given)

2. Birth date

Day

Month

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 this
trip prior to U.S. arrival
9. Airline/Flight No. or Vessel Name
10. The primary purpose of this trip is business:
11. I am (We are) bringing
(a) fruits, vegetables, plants, seeds, food, insects:

Yes

No

Yes

No

(b) meats, animals, animal/wildlife products:

Yes

No

(c) disease agents, cell cultures, snails:

Yes

No

(d) soil or have been on a farm/ranch/pasture:
Yes
No
12. I have (We have) been in close proximity of
(such as touching or handling) livestock:
Yes
No
13. I am (We are) carrying currency or monetary
instruments over $10,000 U.S. or foreign equivalent: Yes
No
(see definition of monetary instruments on reverse)
14. I have (We have) commercial merchandise:
Yes
No
(articles for sale, samples used for soliciting orders,
or goods that are not considered personal effects)
15. R esidents — 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.,
i­ ncluding 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.



 (Signature)

Date (day/month/year)    

For Official Use Only
CBP Form 6059B (10/07)

U.S. Customs and Border Protection Welcomes You to the United States
U.S. Customs and Border Protection is responsible for protecting the United
States against the illegal importation of prohibited items. CBP officers have the
authority to question you and to examine you and your personal property. If
you are one of the travelers selected for an examination, you will be treated in a
courteous, professional, and dignified 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 and are
bringing into the United States.
Visitors (Non-Residents) — Declare the value of all articles that will remain 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 normally entitled
to a duty-free exemption of $800 on items accompanying them. Visitors (nonresidents) are normally entitled to an exemption of $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 to declare such items to a Customs
and Border Protection Officer/Customs and Border Protection Agriculture
Specialist/Fish and Wildlife Inspector can result in penalties and the items may
be subject to seizure.
Controlled substances, obscene articles, and toxic ­substances are ­generally
prohibited entry.
Thank You, and Welcome to the United States.
The transportation of currency or monetary instruments, regardless of the
amount, is legal. However, if you bring in to or take out of the United States
more than $10,000 (U.S. or foreign equivalent, or a combination of both), you are
required by law to file a report on FinCEN 105 (formerly Customs Form 4790)
with U.S. Customs and Border Protection. Monetary instruments include coin,
currency, travelers checks and bearer instruments such as personal or cashiers
checks and stocks and bonds. If you have someone else carry the currency or
monetary instrument for you, you must also file a report on FinCEN 105. Failure
to file the required report or failure to report the total amount that you are carrying
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 AFTER YOU HAVE READ THE IMPORTANT
INFORMATION ABOVE AND MADE A TRUTHFUL DECLARATION.
Description of Articles
CBP
(List may continue on another CBP Form 6059B)
Value
Use Only

Total
Paperwork Reduction Act Notice: The Paperwork Reduction Act says we must tell you why we are collecting this information,
how we will use it, and whether you have to give it to us. The information collected on this form is needed to carry out the Customs,
Agriculture, and currency laws of the United States. CBP requires the information on this form to insure that travelers are complying
with these laws and to allow us to figure and collect the right amount of duty and tax. Your response is mandatory. An agency may
not conduct or sponsor, and a person is not required to respond to a collection of information, unless it displays a valid OMB control
number. The estimated average burden associated with this collection of information is 4 minutes per respondent or record keeper
depending on individual circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing
this burden should be directed to U.S. Customs and Border Protection, Reports Clearance Officer, Information Services Branch,
Washington, DC 20229, and to the Office of Management and Budget, Paperwork Reduction Project (1651-0009), Washington, DC
20503. This form may not be reproduced without approval from the CBP Forms Manager.

CBP Form 6059B (10/07)