Draft Revised Instructions for Customs Dec.

Sample Customs Declaration Form - CBP.gov

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Sample Customs Declaration Form
(01/30/2013)

U.S. Citizens/Lawful
Permanent Residents

U.S. Customs and Border Protection Declaration
Form 6059B - Instructions

For International Visitors

Welcome to the United States!

Clearing CBP

Each individual arriving into the United States must complete the CBP Declaration
Form 6059B. If you are traveling with other immediate family members who reside in
one household, complete one form per family.

Trusted Traveler Programs
For Travel Industry
Personnel
Wait Times - Airport and
Border
Pleasure Boats
Private Flyers
CBP Search Authority

A family is considered people who are related by blood, marriage, domestic
relationship or adoption. People in a domestic relationship include foster children,
stepchildren, half-siblings, legal wards, other dependents or individuals with an in loco
parentis or guardianship relationship. It also includes two adults who are in a
committed relationship including, but not limited to, long-time companions and couples
in civil unions or domestic partnerships, wherein the partners are financially
interdependent and are not married to, or a partner of, anyone else. A “domestic
relationship” does not extend to roommates or other cohabitants who do not meet this
definition.

see also:
in U.S. Citizens/Lawful
Permanent Residents:

Western Hemisphere Travel
Initiative

Know Before You Go

Are You Planning a Trip to
Mexico from the United
States?

Planning To Travel Abroad?

See explanations for information fields with the sample image below.

on cbp.gov:

U.S. Customs and Border Protection Declaration Form - Front
1. Print your last (family) name. Print your first (given) name. Print the first letter of
your middle name.

Locate a Port Of Entry - Air,
Land, or Sea

2. Print your date of birth in the appropriate day/month/year boxes.
Customer Service

3. Print the number of family members traveling with you (do not include yourself).
4. Print your current street address in the United States. If
you are staying at a hotel, include the hotel's name and street
address. Print the city and the state in the appropriate boxes.
5. Print the name of the country that issued your passport.
6. Print your passport number.
7. Print the name of the country where you currently live.
8. Print the name of the country(ies) that you visited on your
trip prior to arriving to the United States.
9. If traveling by airline, print the airline's name and flight
number. If traveling by vessel (ship), print the vessel's name.
10. Mark an X in the Yes or No box. Are you traveling on a
business (work-related) trip?

in Travel

11. Mark an X in the Yes or No box. Are you bringing with
you:
a.
b.
c.
d.

fruits, plants, food, or insects?
meats, animals, or animal/wildlife products?
disease agents, cell cultures, or snails?
soil or have you visited a farm/ranch/pasture outside
the United States?

12. Mark an X in the Yes or No box. Have you or any family
members traveling with you been in close proximity of (such
as touching or handling) livestock outside the United States?
13. Mark an X in the Yes or No box. Are you or any family
members traveling with you bringing $10,000 or more in U.S.
dollars or foreign equivalent in any form into the United
States?
Read definition of monetary instruments on the reverse side
of the form.
Examples: coins, cash, personal or cashier's check, traveler's
checks, money orders, stocks, bonds.
If yes, your must complete the Customs Form 4790.

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Sample Customs Declaration Form - CBP.gov

14. Mark an X in the Yes or No box. Are you or any family
members traveling with you bringing commercial merchandise
into the United States?
Examples: all articles intended to be sold or left in the United
States, samples used for soliciting orders, or goods that are
not considered personal effects.
15. If you are a U.S. resident, print the total value of all goods (including commercial merchandise) you or any family members
traveling with you have purchased or acquired abroad (including gifts for someone else, but not items mailed to the United
States) and are bringing into the United States.
Note: U.S. residents are normally entitled to a duty-free exemption of $800 on items accompanying them.
If you are a visitor (non-U.S. Resident), print the total value of
all goods (including commercial merchandise) you or any family
members traveling with you are bringing into the United States
and will remain in the United States.
Note: Visitors (non-U.S. Residents) are normally entitled to an
exemption of $100.
Declare all articles on this form. For gifts, please indicate the retail
value. Use the reverse side of this form if additional space is
needed to list the items you will declare.
The U.S. Customs officer will determine duty. Duty will be
assessed at the current rate on the first $1,000 above the
exemption.
Read the notice on the reverse side of the form.
Sign the form and print the date.
Keep the complete form with you and hand it to the CBP inspector
when you approach the Customs and Border Protection area.
Controlled substances, obscene articles, and toxic
substances are generally prohibited entry.
U.S. Customs and Border Protection Declaration Form - Back

Thank you, and Welcome to the United
States.

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Sample Customs Declaration Form - CBP.gov

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