OMB Control#: 1651-0002
Expiration date: 07/31/2024
GENERAL DECLARATION
(Outward/Inward)
19 CFR 122.43,122.52,122.54,122.73,122.144
Owner or Operator .............................................................................Carrier Code (if applicable)...................................................................
Marks of Nationality and Registration................................................ Flight No. .......................... Date .....................................................
Departure from ................................................................................... Arrival at ............................................................................................
(Place) (Place)
Total Number of Crew………………………………………………..Total Number of Passengers………………………………………..
I declare that all statements and particulars contained in this General Declaration, and in any supplementary forms required to be
presented with this General Declaration, are complete, exact and true to the best of my knowledge and that all through passengers will
continue/have continued on the flight.
Printed Name _____________________
Title ____________________________
SIGNATURE _________________________________________
Authorized Agent or Aircraft Commander
The information requested by the official General Declaration may be furnished on ICAO Annex 9, Appendix 1, provided the form approximates (but does not exceed) 8 1/2" x 11", and is printed on white paper of appropriate quality.
This form may be printed by private parties provided it conforms to official form in size, wording, arrangement, and quality and color of paper.
Paperwork Reduction Act Statement: An agency may not conduct or sponsor an information collection and a person is not required to respond to this information unless it displays a current valid OMB control number and an expiration date. The control number for this collection is 1651-0002. The obligation to respond is mandatory. The estimated average time to complete this application is 2 minutes. If you have any comments regarding the burden estimate you can write to U.S. Customs and Border Protection, Office of Regulations and Rulings, 90K Street, NE, Washington DC 20002.
INSTRUCTIONS
Owner or Operator – In the case of a commercial air carrier, this shall be the entity whose bond secures the flight.
Carrier Code – The carrier code shall be the IATA or ICAO code assigned to the owner or operator. If the carrier does not have a carrier code, the code provided by CBP shall be used. This line should be left blank if not applicable.
Marks of Nationality and Registration – This is commonly known as the aircraft tail number. It shall include leading letters that indicate country of registration.
Flight No. – For commercial carriers, this shall be the flight number identified on passengers’ tickets and shall include the carrier code if different from above. This line should be left blank if not applicable.
Date – This is the date that the carrier arrives or departs the United States. If a numerical date it used, it shall follow the format month/day/year.
Departure from – This is the location from which the flight departs and shall be the IATO or ICAO code of the airport, as appropriate. If no such code exists, the name of the airport shall be written including city, state, and/or country, as applicable.
Arrival at – This is the location at which the flight arrives and shall be the IATO or ICAO code of the airport, as appropriate. If no such code exists, the name of the airport shall be written including city, state, and/or country, as applicable.
Total Number of Crew – For the purposes of this form, a crew member means a pilot, copilot, flight engineer, airline management personnel authorized to travel in the cockpit, cabin crew, and relief crew (also known as “deadheading crew”).
Total Number of Passengers – The term passenger means any person, including a Federal Aviation Administration (FAA) Aviation Security Inspector with valid credentials and authorization, being transported on a commercial aircraft who is not a crew member.
Printed Name – This shall be the printed name of the authorized agent or aircraft commander who is signing this form.
Title – This is the job title of the person signing this form. It may also be the aircraft commander or owner.
Signature – This is the signature of the party submitting the form.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | HERRON, MICHELLE E |
File Modified | 0000-00-00 |
File Created | 2023-08-01 |