Each arriving traveler or head of family must provide the following information (only ONE written declaration per family is required): 每一位入境美国的游客或一家之主必须提供以下资料 (一个家庭只须申报一份):
2. Birth date∶ Day ________ Month ________ Year ________ 〈出生日期∶ 日 ________ 月 ________ 年 ________〉:
3. Number of family members traveling with you〈与你同行的家庭成员人数〉:
4. a. U.S. street address (hotel name/destination)∶〈在美居住地址(旅馆名称/目的地〉: b. City 〈城市〉 c. State 〈州〉
5. Passport issue by (country)∶〈发照国家〉
6. Passport number∶〈护照号码〉
7. Country of Residence∶〈居住国家〉
8. Countries visited on this trip prior to U.S. arrival∶〈此次旅游时来美国之前去过的国家〉
9. Airline/Flight No. or Vessel Name: 〈航空公司/班机号码或船名〉:
10. The purpose of my trip is or was BUSINESS ○ YES ○NO〈此次旅程的目的主要是商务 ○ 是 ○否〉
11. I am (We are) bringing∶ 〈我(我们)携带〉∶ a. fruits, plants, food, or insects? 〈水果,植物,食物或昆虫?〉 b. meats, animals, or animal/wildlife products? 〈肉类、动物或动物/野生动物制品?〉 c. disease agents, cell cultures, or snails? 〈带病原体、细胞培养或蜗牛?〉 d. soil or have you visited a farm/ranch/pasture outside the United States? 〈土壤或你曾经去过美国境外的农场或牧场吗?〉
12. I have (We have) been in close proximity of (such as touching or handling) livestock outside the United States?∶〈我有(我们有)靠近(如触碰或接触)牲畜○ 是 ○否?〉
13. I am (we are) carrying currency or monetary instruments over ,000 U.S. or the foreign equivalent. ○ YES ○NO 〈你携带现金或财物品,其价值超过一万美金或相当於一万美金的外币吗? ○是 ○否〉
14. I have (We have) commercial merchandise: (article for sale, samples used for soliciting orders, or goods that are not considered personal effects)○ YES ○NO〈我(我们)有携带商品∶(贩卖物品、商业样品或任何不属於个人所有的物品)○是 ○否〉
15. Residents - the total value of all good, including commercial merchandise I/We have purchased or acquired abroad, (including gifts for someone else, but not items mailed to the U.S.) and am/are bringing to the U.S. is:〈美国居民- 我们带入美国所有物品(包含商品及礼品,但不包含邮寄入美国的物品)的种价值为∶〉
Visitors - the total value of all article that will remain in the U.S., including commercial merchandise is: 〈观光客- 将留在美国境内的物品价值为(包含商品)∶
Read the instruction on the back of this form. Space is provided to list all the items you must declare.〈请阅本表读背面的说明,请将须申报的物品在空格内列出〉
I HAVE READ THE IMPORTANT INFORMATION ON THE REVERSE SIDE OF THIS FORM AND HAVE MADE A TRUTHFUL DECLARATION. 〈我已阅读过背面的说明,且已就实申报〉