WELCOME TO THE UNITED STATES | | 欢迎来到美国 |
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DEPARTMENT OF THE TREASURY UNITED STATES CUSTOMS SERVICE | | 财政部 美国海关署 |
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CUSTOM DECLARATION | | 海关申报表 |
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Each arriving traveler or head of family must provide the following information (only ONE written declaration per family is required): | | 每位入关的旅游者或一家之主必须提供以下数据 (一个家庭只须申报一份): |
1. Family Name ________First (Given)________ Middle________ | | 1. 姓氏 ________名字_______ 中间名________ |
2. Birth date | | 2. 出生日期: |
____Day____Month____Year | | ____日____ 月____年 |
3. Number of family members traveling with you: | | 3. 与你同行的家庭成员人数: |
4. U.S. Address: | | 4. 在美地址: |
5. Passport issued by (country) | | 5. 护照发照(国家) |
6. Passport Number | | 6. 护照号码 |
7. Country of Residence | | 7. 居住国家 |
8. Countries visited on this trip prior to U.S. arrival | | 8. 到美国前造访过的国家 |
9. Airline/Flight No: | | 9. 航空公司/航班号: |
10. The primary purpose of this trip is business. ○YES ○ NO | | 10. 此次旅程的主要目的是商务?○ 是 ○ 否 |
11. 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 U.S.YES ○ NO ○ | | 11. 您携带水果、植物、肉类、食品、土壤、鸟类、蜗牛、其它动物和农产品,或您一直居住在美国以外的农村或牧场吗?是 ○ 否 ○ |
12. I am/we are carrying currency or monetary instruments over $10000 U.S. or the foreign equivalent.YES ○ NO ○ | | 12. 您携带现金或珍贵物品,其价值超过一 万美金或相当于一万美金的外币吗?是 ○ 否 ○ |
13. I have (We have) commercial merchandise? (articles for sale, samples used for soliciting orders, or goods that are not considered personal effects.)YES ○ NO ○ | | 13. 您有携带任何商品吗?(贩卖之商品、订购之样本等任何非属私人之物品)是 ○ 否 ○ |
14. The total value of all goods I/we purchased or acquired abroad and am/are bringing to the U.S. is (see instructions under Merchandise on reverse side; visitors should report value of gifts only):$___________________ U.S. Dollars | | 14. 您境外购买或获得并带入美国所有物品总价值(参看 背面商品栏目; 访问者只须申报礼品价值): $ _________________ 美元 |
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I have read the important information on the reverse side of this form and have made a truthful declaration. | | 我已阅读过这表格背面之重要须知,并据实以报。 |
SIGNATURE________________ | | 签名________________ |
Date________________ | | 日期________________ |