Family Name / Surname

First Name(s)

Sex

Date of Birth

Marital Status

Country of Birth

Nationality

Occupation

Town/City of Residence

State/Province

Zip/Postal Code

Country of Residence

Passport No.

Place of Issue

Email Address

Contact Number

Accompdation Type

Accomodations

Other Accommodation

Contact Address in Dominica (in full)

Contact Community in Dominica

Purpose of visit

Other

Length of Stay in Dominica (days)

Port of Last Departure

How are you travelling to Dominica?

Airline

Ferries

Other Airline

Other Ferry

Arrival Flight/Ship Name

Port of Dissembarkation

Arrival Date

Arrival Time

I confirm that the above is true and correct:

NOTICE TO PASSENGERS

Customs Declaration

Every passanger or head of the family travelling together with a spouse and children under the age of 18, is required to complete thi Section

1. Number of pieces of luggage

Accompanying Luggage

(Checkeded luggage and hand luggage)

Unaccompanying Luggage

(Luggage sent by Air/Sea freight)

Countries visited in the last six (6) weeks

Country 1

Country 2

Country 3

Residents - 18 yrs and over are entitled to (EC $400) duty free allowance per year on personal and household effects, not in commercial quantity as well as 227g tobacco, or Cigarettes not exceeding 200 or Cigars not exceeding 50, 1 litre of spirits or wine.

Visitor - Declare all dutiable articles whether remaining in Dominica or for subsequent re-export.

(If you have doubt, declare all items to the Customs Officer)

Description of Articles	#Value in Currency

I certify that all statements I have made in this declaration are true, correct and complete. I understand that failure to make a full declaration is an offence and can result in seizure of the goods, fines and/or imprisonment.

2. I am (We are) bringing:	Yes No
(a) fruits, plants, cut flowers, vegetables, soil, meat, live animals and organisms, honey, wildlife products, plant material, food, animal products or live birds
(b) pharmaceuticals, narcotics and other illicit drugs, and biological substances
(c) arms, ammunition, explosives, fireworks, toy guns or other weapons
3. I have (We have) commercial merchandise: (articles for sale, samples used for soliciting orders or goods that are not considered personal effects)
4. I am (we are) carrying currency or monetary instruments over (EC $10,000) or equivalent

LANDING CARD

Please complete clearly in English

NOTICE TO PASSENGERS

Customs Declaration