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obsidian-yanxin/documents/travel/customs_declaration/海关申报表.md
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travel-doc travel Jiang Xianlu, Xue Fengqin 海关申报表.pdf

Page 1: 海关申报单 (Customs Declaration - Chinese Version)

U.S. Customs and Border Protection 19 CFR 122.27, 148.12, 148.13, 148.110, 148.111, 1498; 31 CFR 5316 批准表格 OMB NO. 1651-0009

每位入境旅客或家庭负责人必须提供以下资料(每个家庭只需填写一份申报单):

# Field (Chinese) Value
1 Jiang
Xianlu
中间名
2 出生日期 日 28 月 01 年 68
3 随行家庭成员人数 2
4(a) 在美国的地址街名(旅馆名称/目的地) 1652 W 6th Street Apt. R
4(b) Austin
4(c) Texas
5 发照地(国家) China
6 护照号码 E38284127
7 居住国 China
8 这次抵达美国之前曾去过的国家 China
9 航空公司/班机号码或船名 HU 495

申报问题

# Question Answer
10 这次旅行的主要目的是业务出差 否 X
11(a) 水果、蔬菜、植物、种子、食品、昆虫 否 X
11(b) 肉类、动物、动物/野生动物产品 否 X
11(c) 疾病媒体、细胞培养体、蜗牛 否 X
11(d) 土壤或曾经到过农场/牧场/饲养场 否 X
12 曾经非常接近(如摸过或者处理过)牲畜 否 X
13 携带超过 10,000 美元或相等数额的外国货币的现金或代金 否 X
14 携带商品(可供销售的物品、用于招揽订单的样品、或不属于个人用品的物品) 否 X

申报价值

Category Value
15. 居民 — 总价值 $ —
来访者 — 将留在美国的所有物品(包括商品)的总价值 $ 500

签名: (signed) 日期:


Page 2: Customs Declaration (English Version)

U.S. Customs and Border Protection 19 CFR 122.27, 148.12, 148.13, 148.110, 148.111, 1498; 31 CFR 5316 FORM APPROVED OMB NO. 1651-0009

Each arriving traveler or responsible family member must provide the following information (only ONE written declaration per family is required):

# Field Value
1 Family Name Xue
First (Given) Fengqin
Middle
2 Birth date Day 06 Month 04 Year 65
3 Number of Family members traveling with you 2
4(a) U.S. Street Address (hotel name/destination) 1652 W 6th Street Apt. R
4(b) City Austin
4(c) State Texas
5 Passport issued by (country) China
6 Passport number G49056250
7 Country of Residence China
8 Countries visited on this trip prior to U.S. arrival China
9 Airline/Flight No. or Vessel Name HU 495

Declaration Questions

# Question Answer
10 The primary purpose of this trip is business No X
11(a) fruits, vegetables, plants, seeds, food, insects No X
11(b) meats, animals, animal/wildlife products No X
11(c) disease agents, cell cultures, snails No X
11(d) soil or have been on a farm/ranch/pasture No X
12 I have (We have) been in close proximity of (such as touching or handling) livestock No X
13 I am (We are) carrying currency or monetary instruments over $10,000 U.S. or foreign equivalent No X
14 I have (We have) commercial merchandise No X

Declared Value

Category Value
15. Residents — total value of all goods $ —
Visitors — total value of all articles that will remain in the U.S., including commercial merchandise $ 500

I HAVE READ THE IMPORTANT INFORMATION ON THE REVERSE SIDE OF THIS FORM AND HAVE MADE A TRUTHFUL DECLARATION.

Signature: (signed) Date: