Canada Border

Services Agency
Agence des services
frontaliers du Canada Declaration Card
PAX For Agency Use Only
R U.S. V OV Cr O
Instructions
Part A All travellers (living at the same address) Please print in capital letters.
All travellers can be identified on a Canada
Border Services Agency (CBSA) Declaration Last name, first name and initials
Card. You may list up to four people living at the
same address on one card. Each traveller is 1
responsible for his or her own declaration. Date of birth: Y Y M M D D Citizenship:
Each traveller is responsible for reporting YY - MM - DD
currency and/or monetary instruments Last name, first name and initials

Fold along line and detach

totaling CAN$10,000 or more that are in his
or her actual possession or baggage. 2
Date of birth: Y Y M M D D Citizenship:
Under the law, failure to properly declare goods, YY - MM - DD
currency and/or monetary instruments brought Last name, first name and initials
into Canada may result in seizure action,
monetary penalties and/or criminal prosecution. 3
Date of birth: Y Y M M D D Citizenship:
Information provided is collected under the YY - MM - DD
authority of Section 12 of the Customs Act
Last name, first name and initials
to facilitate compliance with the travellers
obligation with Subsection 5(3), Reporting of
4
Imported Goods Regulations, and enables Date of birth:
the collection of duty and taxes payable on Y Y M M D D Citizenship:
YY - MM - DD
imported goods. This information may be
HOME ADDRESS Number, street, apartment No. City/Town
disclosed to other government departments and
agencies, police forces and other Countries to
administer or enforce Canadian Legislation. Prov./State Country Postal/Zip code
Individuals have the right of access to and/or
can make corrections of their personal
information under the Privacy Act. The Arriving by: Purpose of trip: Arriving from:
information is described within Info Source, Air Rail Marine Highway Study U.S. only
Traveller Declaration Cards Personal Airline/flight No., train No. or vessel name Personal Other country direct
information Bank CBSA PPU 018 at
Business Other country via U.S.
http://www.cbsa-asfc.gc.ca/.
I am/we are bringing into Canada: Yes No
Part B Visitors to Canada Firearms or other weapons
(e.g. switchblades, Mace or pepper spray).
The following duty-free allowances apply to
each visitor entering into Canada: Commercial goods, whether or not for resale
(e.g. samples, tools, equipment).
Gifts (excludes alcohol and tobacco)
valued at no more than CAN$60 each. Meat, fish, seafood, eggs, dairy products, fruits,
vegetables, seeds, nuts, plants, flowers, wood,
Alcohol and tobacco (see table below *). animals, birds, insects, and any parts, products or
by-products of any of the foregoing.
Part C Residents of Canada Currency and/or monetary instruments totaling
Each resident returning to Canada is CAN$10,000 or more.
entitled to one of the following personal
exemptions (include all goods and/or gifts I/we have unaccompanied goods.
purchased or received abroad):
I/we have visited a farm and will be going to a farm in
24 hours absence from Canada: CAN$200 Canada.
Fold along line and detach

Not claimable if goods exceed CAN$200.
Part B Visitors to Canada
Alcohol, tobacco and unaccompanied goods
cannot be claimed. Duration of stay in Canada Yes No
Do you or any person listed above exceed the duty-free
MM# 20171317 DRC 9355 - 1A 1B 1C

48 hours absence from Canada: CAN$800 days allowances per person? (See instructions on the left.)
This includes alcohol and tobacco (see table Part C Residents of Canada
below *). Unaccompanied goods cannot be Yes No
claimed. Do you or any person listed above exceed the exemptions per person?
(See instructions on the left.)
7 days absence from Canada: CAN$800
This includes alcohol, tobacco (see table Complete in the same order as Part A
below *) and unaccompanied goods. Value of goods CAN$ Value of goods CAN$
Date left Canada Date left Canada
purchased or received abroad purchased or received abroad
* Alcohol and tobacco table YY - MM - DD (including gifts, alcohol & tobacco) YY - MM - DD (including gifts, alcohol & tobacco)
1 Y Y M M D D 3 Y Y M M D D
1.5 L of wine or 1.14 L of liquor or 24 x
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.
1 Date
200 cigarettes, 200 tobacco sticks, 50 Y Y M M D D
2 YY - MM - DD
cigars or cigarillos and 200 grams of
manufactured tobacco (Special Duty 3 4
may apply).
E311 (16) Protected A when completed B

Do not fold Declaration Card