Instructions Declaration Card

– For Agency Use Only –

All travellers can be identified on a Canada PAX
Border Services Agency (CBSA) Declaration R U.S. V OV Cr O
Card. You may list up to four people living at the
same address on one card. Each traveller is Part A All travellers (living at the same address) – Please print in capital letters.
responsible for his or her own declaration. Last name, first name and initials
Each traveller is responsible for reporting
currency and/or monetary instruments
totaling CAN$10,000 or more that are in his
1
Date of birth:
or her actual possession or baggage. Y Y M M D D Citizenship:
YY - MM - DD
Under the law, failure to properly declare goods, Last name, first name and initials
currency and/or monetary instruments brought
into Canada may result in seizure action, 2
monetary penalties and/or criminal prosecution. Date of birth:
Y Y M M D D Citizenship:
YY - MM - DD
Information provided is collected under the Last name, first name and initials
authority of Section 12 of the Customs Act to
facilitate compliance with the traveller’s 3
obligation with Subsection 5(3), Reporting of Date of birth:
Imported Goods Regulations, and enables the Y Y M M D D Citizenship:
YY - MM - DD
collection of duty and taxes payable on Last name, first name and initials
imported goods. This information may be
disclosed to other government departments
and agencies, police forces and other 4
Date of birth:
Countries to administer or enforce Canadian Y Y M M D D Citizenship:
YY - MM - DD
Legislation.
HOME ADDRESS – Number, street, apartment No. City/Town
Individuals have the right of access to and/or
can make corrections of their personal
information under the Privacy Act. The Prov./State Country Postal/Zip code
information is described within Info Source,
Traveller Declaration Cards Personal
information Bank CBSA PPU 018 at Arriving by: Purpose of trip: Arriving from:
http://www.cbsa-asfc.gc.ca/.
Air Rail Marine Highway Study U.S. only
Airline/flight No., train No. or vessel name Personal Other country direct
Part B – Visitors to Canada Business Other country via U.S.
The following duty-free allowances apply to I am/we are bringing into Canada: Yes No
each visitor entering into Canada: • Firearms or other weapons
(e.g. switchblades, Mace or pepper spray).
 Gifts (excludes alcohol and tobacco)
valued at no more than CAN$60 each. • Commercial goods, whether or not for resale
(e.g. samples, tools, equipment).
 Alcohol and tobacco (see table below *). • Meat, fish, seafood, eggs, dairy products, fruits,
vegetables, seeds, nuts, plants, flowers, wood,
animals, birds, insects, and any parts, products or
Part C – Residents of Canada by-products of any of the foregoing.
Each resident returning to Canada is entitled to • Currency and/or monetary instruments totaling
one of the following personal exemptions CAN$10,000 or more.
(include all goods and/or gifts purchased or • Cannabis or goods containing cannabis.
received abroad):
I/we have unaccompanied goods.
 24 hours absence from Canada: CAN$200
Not claimable if goods exceed CAN$200. I/we have visited a farm and will be going to a farm
Alcohol, tobacco and unaccompanied goods in Canada.
cannot be claimed. Part B Visitors to Canada
 48 hours absence from Canada: CAN$800 Duration of stay in Canada Do you or any person listed above exceed the duty-free Yes No
This includes alcohol and tobacco (see table allowances per person? (See instructions on the left.)
days
below *). Unaccompanied goods cannot be
claimed. Part C Residents of Canada
 7 days absence from Canada: CAN$800 Yes No
This includes alcohol, tobacco (see table Do you or any person listed above exceed the exemptions per person?
(See instructions on the left.)
below *) and unaccompanied goods.
Complete in the same order as Part A

Date left Canada Value of goods – CAN$ Date left Canada Value of goods – CAN$
* Alcohol and tobacco table purchased or received abroad purchased or received abroad
YY - MM - DD (including gifts, alcohol & tobacco) YY - MM - DD (including gifts, alcohol & tobacco)

1.5 L of wine or 1.14 L of liquor or 24 x 1 Y Y M M D D 3 Y Y M M D D

355 ml cans or bottles (8.5 L) of beer or 2 Y Y M M D D 4 Y Y M M D D
ale. (You must be of legal age in the
province of importation.) Part D Signatures (age 16 and older): I certify that my declaration is true and complete.

200 cigarettes, 200 tobacco sticks, 50 1 Date

Y Y M M D D
cigars or cigarillos and 200 grams of YY - MM - DD
2
manufactured tobacco (Special Duty
may apply). 3 4
E311 (18) Protected A when completed

Do not fold Declaration Card