WELCOME TO THE UNITED STATES |
|
欢迎来到美国 |
|
DEPARTMENT
OF THE TREASURY
UNITED STATES CUSTOMS SERVICE |
|
财政部
美国海关署 |
|
| CUSTOM
DECLARATION |
|
海关申报 |
|
|
|
| Each
arriving traveler or head of family must provide the following information
(only ONE written declaration per family is required): |
|
每个入关的旅游者或一家之主必须提供如下资料 (一个家庭只须申报一份): |
|
|
|
|
|
1. Family Name: |
|
1. 姓: |
|
2. First Name |
|
2. 名 |
|
|
|
|
|
3. Middle Initial |
|
3. 中间名 |
|
|
|
|
|
4. Date of Birth: (Day/Month/Year) |
|
4. 出生日期: 日/月/年 |
|
5. Airline/Flight No. :
|
|
5.
航空公司/航班号:
|
| 6. Number of family members traveling with you |
|
6. 与你同 行的家庭成员人数: |
|
7. (a)Country of Citizenship:
|
|
7.(a)国籍: |
|
|
|
|
|
7. (b)Country of Residence: |
|
7. (b)所居住国家: |
|
8. (a) U.S. Address (Street Number/Hotel/Mailing Address to U.S.): |
|
8.(a)在美国地址（街道地址/旅馆/在美国的通讯地址）: |
| 8. (b) U.S. Address (City):
|
|
8.(b)在美国地址（城市）:
|
| 8. (c) U.S. Address (State):
|
|
8.(c)在美国地址（州）:
|
|
9. Countries visited on this trip prior to U.S. arrival |
|
9. 在到达美国之前此行所访问过的国家 |
10. The purpose of my trip is or was
BUSINESS Personal |
|
10. 此次旅程的目的是
商务 个人 |
|
|
11.
I am (we are) bringing fruits, plants,
meats, food,
soil, birds, snails, other
live animals,
farm products; or, have
been on a farm or ranch outside
the U.S. :
|
YES
NO |
|
|
| 11. 你携带水果, 植物, 肉类, 食品, 土壤, 鸟类,
蜗牛, 其他动物和农产品, 或你 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 equiralent. |
YES
NO |
|
|
| 12. 我（我们）携带了超过一万美金或等值的外国货币或有价证券 |
是 否 |
|
13.
I have (we have) commercial merchandise, U.S.
or foreign:(Check one box only) |
YES
NO |
|
|
| 13. 我（我们）携带了美国或外国商品：（只能在一个方框内打勾） |
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. 我（我们）在国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 |
|
|
|
|
|
| SIGN
ON RESERSE SIDE AFTER YOU READ WARNING.(Do not write below this
line.) |
|
在你阅读警告之后请在背面签字
(不要在此线下面签字) |
|
|
|
|
|
|
INSPECTOR’S NAME STAMP AREA |
|
检察员姓名 盖章区域 |
|
|
|
|
|
BADGE NO |
|
徽章号码 |
| |
|
|