加拿大入境卡（英文样本） 

Declaration CardPAXR– For Agency Use Only –U.S. VOVCrOInstructionsAll travellers must be identified on aCanada Border Services Agency (CBSA)Declaration Card. You may list up to fourpeople living at the same address on onecard. Each traveller is responsible forhis or her own declaration.Part AAll travellers (living at the same address) – Please print in capital letters.Last name, first name and initials1Date of birth:YYMMDDCitizenship:Last name, first name and initialsDetach instructions2Date of birth:YYMMDDUnder the law, failure to properly declaregoods, currency and/or monetaryinstruments brought into Canada mayresult in seizure action, monetary penaltiesand/or criminal prosecution.Information from this declaration will beused for CBSA control purposes, andmay be shared with other governmentdepartments to enforce Canadian laws.For more information see Info Source (ref. no. CBSA PPU 018), at a publiclibrary or visit http://infosource.gc.ca.Citizenship:Last name, first name and initials3Date of birth:YYMMDDCitizenship:Last name, first name and initials4Date of birth:YYMMDDCitizenship:City/TownPostal/Zip codeHOME ADDRESS – Number, street, apartment No.Prov./StateCountryPart B – Visitors to CanadaThe following duty-free allowances applyto each visitor entering into Canada:■ Gifts (excludes alcohol and tobacco)Arriving by:AirRailMarineHighwayAirline/flight No., train No. or vessel name valued at no more than CAN$60 each.■ 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 ale.■ 200 cigarettes, 200 tobacco sticks, 50 cigars or cigarillos and 200 grams of manufactured tobacco. Purpose ofStudyPersonalBusinessArriving from:U.S. onlyOther country directOther country via U.S.YesNo– For Agency Use Only –I am/we are bringing into Canada: ?Firearms or other weapons (e.g. switchblades, Mace or pepper spray). ?Commercial goods, whether or not for resale(e.g. samples, tools, equipment).?Meat/meat products; dairy products; fruits;vegetables; seeds; nuts; plants and animals or theirparts/products; cut flowers; soil; wood/woodproducts; birds; insects.?Currency and/or monetary instruments of a valuetotalling CAN$10,000 or more per person.I/we have shipped goods that are not accompanyingme/us.I/we have visited a farm and will be going to a farm inCanada.Part C – Residents of CanadaEach resident returning to Canada isentitled to one of the following personalexemptions based on his/her time absentfrom Canada (include all goods and/orgifts purchased or received abroad):■ 24 hours: CAN$50 Not claimable if goods exceed $50. Detach instructions Alcohol and tobacco cannot be claimed.■ 48 hours: CAN$400Part BVisitors to CanadaDuration of stay in CanadadaysPart CResidents of Canada This includes alcohol and tobacco (see table below).■ 7 days: CAN$750Do you or any person listed above exceed the duty-freeallowances per person? (See instructions on the left.)YesNo This includes alcohol and tobacco (see table below).Alcohol and tobacco exemption table1.5 L of wine or 1.14 L of liquor or 24 x 355 ml cans or bottles (8.5 L) of beer or ale. (You must be of legal agein the province of importation.)200 cigarettes, 200 tobacco sticks, 50 cigars or cigarillos and 200 grams of manufactured tobacco(Special Duty may apply). Do you or any person listed above exceed the exemptions per person?(See instructions on the left.)Complete in the same order as Part ADate left CanadaYY - MM - DDValue of goods – CAN$purchased or received abroad(including gifts, alcohol & tobacco)DDYesNoDate left CanadaYY - MM - DDValue of goods – CAN$purchased or received abroad(including gifts, alcohol & tobacco)DD12123YYYYMMMMDD34YYYYMMMMDDPart DSignatures (age 16 and older): I certify that my declaration is true and complete.DateYYMMDD4E311 (08/04)Protected A when completedBSF311Do not fold Declaration CardA580G1.FRP

(08/04)