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5) Currency other than Russian rubles (bank notes, exchequer bills, coins),
payment vouchers (cheques, bills, letters of credit, etc.), securities (shares,
bonds,etc.) in foreign curreencies, precious metals (gold, silver, platinum, metals of
platinum group) in any form or condition, crude and processed natural precious
stones (diamonds, brilliants, rubies, emeralds, sapphires and pearls), jewelry and
other articles made of precious metals and precious stones, and scrap thereof, as
well as properly papers:
Description Amount/quantity For official use
in figures/in words
6) Russian rubles, other currency, payment vouchers, valuables and any objects
belonging to other persons …………………………………………………………
I am aware that, in addition to the objects listed in the Custom Declaration, I
must submit for inspection: printed matter, manuscripts, films, sound recordings,
postage stamps, graphics, etc. plants, fruit, seeds, live animals and birds, as well as
raw foodstaffs of animal origin and slaughtered fowl.
I also declare that my luggage sent separately consists of ……… pieces.
Date Owner of luggage ( signed)
…….. …………………………….
1.4.2 CUSTOMS DECLARATION customs use only Department of the
Treasury United States Customs Service
Each arriving traveler or responsible family member must provide the
following information (only ONE written declaration per family is required):
1) Family Name………………………………………………………………
2) First {Given) Name………………………………………………………….
3) Middle initial(s)……………………………………………………………...
4) Birth Date (day/mo/yr)………………………………………………………
5) Airline/Flight No. Or Vessel Name or Vehicle License No. ………………..
6) Number of Family Members Travelling with You …………………………
7) (a) Country or Citizenship……………………………………………….…
8) (b) Country of Residence……………………………………………………
9) (a) U.S.Address ( Street Number/Hotel/Mailing Address in U.S.)…………
10) (b) U.S. Address ( City )……. ……………………………………………..
11) (c) U.S. Address ( State ) …………………………………………………
12) Countries visited on this trip prior to U.S. arrival …………………………
13) The purpose of my (our) trip is or was Business Personal
(Check one or both boxes, if applicable)
14) I am (We are) bringing fruits, plants, meats, food, Yes No
soil, birds, snails, other live animals, wildlife products, farm
products; or, have been on a farm or ranch outside the U.S.
15) I am (We are) carrying currency or monetary Yes No
5) Currency other than Russian rubles (bank notes, exchequer bills, coins), payment vouchers (cheques, bills, letters of credit, etc.), securities (shares, bonds,etc.) in foreign curreencies, precious metals (gold, silver, platinum, metals of platinum group) in any form or condition, crude and processed natural precious stones (diamonds, brilliants, rubies, emeralds, sapphires and pearls), jewelry and other articles made of precious metals and precious stones, and scrap thereof, as well as properly papers: Description Amount/quantity For official use in figures/in words 6) Russian rubles, other currency, payment vouchers, valuables and any objects belonging to other persons ………………………………………………………… I am aware that, in addition to the objects listed in the Custom Declaration, I must submit for inspection: printed matter, manuscripts, films, sound recordings, postage stamps, graphics, etc. plants, fruit, seeds, live animals and birds, as well as raw foodstaffs of animal origin and slaughtered fowl. I also declare that my luggage sent separately consists of ……… pieces. Date Owner of luggage ( signed) …….. ……………………………. 1.4.2 CUSTOMS DECLARATION customs use only Department of the Treasury United States Customs Service Each arriving traveler or responsible family member must provide the following information (only ONE written declaration per family is required): 1) Family Name……………………………………………………………… 2) First {Given) Name…………………………………………………………. 3) Middle initial(s)……………………………………………………………... 4) Birth Date (day/mo/yr)……………………………………………………… 5) Airline/Flight No. Or Vessel Name or Vehicle License No. ……………….. 6) Number of Family Members Travelling with You ………………………… 7) (a) Country or Citizenship……………………………………………….… 8) (b) Country of Residence…………………………………………………… 9) (a) U.S.Address ( Street Number/Hotel/Mailing Address in U.S.)………… 10) (b) U.S. Address ( City )……. …………………………………………….. 11) (c) U.S. Address ( State ) ………………………………………………… 12) Countries visited on this trip prior to U.S. arrival ………………………… 13) The purpose of my (our) trip is or was Business Personal (Check one or both boxes, if applicable) 14) I am (We are) bringing fruits, plants, meats, food, Yes No soil, birds, snails, other live animals, wildlife products, farm products; or, have been on a farm or ranch outside the U.S. 15) I am (We are) carrying currency or monetary Yes No 7
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