Family Name / Surname
First Name(s)
Address in Dominica
Date of Birth
Passport No.

Countries visited in the last six (6) weeks

2. I am (We are) bringing:
Yes   No
3. I have (We have) commercial merchandise:

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
Accompanying Individuals
Name Date of Birth Relation