PROTECTED B when completed

TRAVELLER DECLARATION CARD TO BE USED BY CANADIAN RESIDENTS TO DECLARE GOODS

Traveller Declaration Card Number (Internal Use Only)

Section A - To be completed by Program Member (Traveller)FAST CDRPNEXUS CANPASS - AIR U.S. Pass I.D. or CA Client ID or CDRP Document Number

Section B - To be completed by Program Member (Traveller): Personal information and residential addressSurname First name Middle name (in full) Date of birth (YYYY/MM/DD)

Gender MaleFemale

Telephone number (xxx) xxx-xxxx E-mail address

Street address Apt. no. City Province of Residence Postal code

Section C - Complete this section if mailing address differs from residential addressStreet address Apt. no. City Province Postal code Country

Section D - Total amount declared must include your personal exemption. See instruction below for further detailsLess than 24 Hour 24 Hour 48 Hour 7 Day

The goods are valued inU.S. dollars CAN dollars

The goods were made inCAN USA Other

Select the Categories of your goods by using the Tariff Guide provided below.

Category 1 $ Category 2 $

Category 3 $ Category 4 $

Category 5 $ Category 6 $

Category 7 $

Alcohol and Tobacco Products

Enter both dollar value and quantity of beer, wine, liquor, cigarettes, or tobacco.

A - Dollar Value B - Quantity

Beer $ Dozen and Bottles/Cans

Wine $ Litres

Liquor $ Litres

Cigarettes Made in Canada $ Cartons and Packs

Tobacco Made in Canada $ 200g

** You CANNOT use a TDC to declare the following items: cigars, cigarillos, OR any cigarettes, loose tobacco or tobacco sticks not marked 'Canada Duty Paid - Droit Acquitté'. In addition, restricted, prohibited or controlled goods or any goods requiring a permit cannot be declared using a TDC.

Section E - Credit Card Information

VISA MASTERCARD AMEXCredit Card number Name as it appears on Credit Card Expiry Date (MM/YY)

I understand that by signing this section my credit card will be charged any applicable duties and taxes that may be owing for the items that I declared on this form that are over my personal exemption. I also understand that this credit card number will be kept on file for future subsequent transactions.

Print name Signature Date (YYYY/MM/DD)

Section F - Program Member (Traveller) Certification

I certify that all information given on this form was provided voluntarily and is true and complete. I certify that I understand the terms and conditions of the Traveller Declaration Card (TDC). I agree to pay all duties and taxes applicable on the goods that I have declared on my TDC. I hereby authorize CBSA to use the credit card number that I have provided for this purpose. I certify that the credit card is valid and that I will provide CBSA with amended information as required. DISCLOSURE The authority to collect the personal information derives from section 11.1 of the Customs Act; and the regulations made under that provision. It will be used to report and pay federal and provincial duty and tax revenue collected through the various alternative reporting programs for Travellers, and also for statistical purposes. The personal information on this form is protected in accordance with the Privacy Act and other laws. The information may be disclosed to internal or external bodies as a consistent use for other provisions listed under section 8(2) of the Privacy Act. Failure to comply and pay amounts owing is a contravention of the Customs Act and may result in the cancellation of your membership. You have the right to access and/or to request correction of your personal information under the Privacy Act. Further information about this collection may be found by referring to Traveller Declaration Cards, CBSA PPU 018. For more information, visit www.infosource.gc.ca

Print name Signature Date (YYYY/MM/DD)

E601-Fill-E (14-05)

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How to complete your Traveller Declaration Card (TDC) 1. Complete one card per person and per membership. Use black ink. Do not use green or light blue ink. Do not use a fine-tipped pen. 2. Please note that any changes to personal information noted in your TDC will not be transferred to your membership profile. You must

contact one of the 3 Canadian Processing Centers listed below to update any personal information. 3. Exemption: Check the appropriate exemption box only if you qualify for one of these exemptions. If you have been gone less than 24 hours

do not check anything. 4. Check one of the boxes to indicate whether the goods you are declaring are valued in U.S. or Canadian dollars. The dollar amounts

declared cannot be split between the two currencies. 5. Check one of the boxes to indicate where the goods were made. If they were made in a country other than the U.S. or Canada, check the

box marked "Other". 6. Select the categories for your goods by using the Tariff Guide. 7. Print the actual dollar value of your goods in the space provided beside the applicable category numbers. 8. Note that alcohol and tobacco products can only be declared by a traveler who meets the age requirements of the province where they

enter. Beer, wine, liquor: Indicate (A) the actual dollar value of these goods and (B) the applicable quantity (litres or dozen) in the space provided. Cigarettes and tobacco: Indicate (A) the actual dollar value and (B) the quantity (e.g. pack of 20 or 200g) of these goods in the space provided. If the cigarettes or tobacco were made in Canada, check the appropriate box.

9. Sign and date the declaration card. 10. You CANNOT use a TDC to declare the following items: Cigars, cigarillos, OR any cigarettes, loose tobacco or tobacco sticks NOT marked

"Canada Duty Paid - Droit Acquitté". In addition, restricted, prohibited or controlled goods or any good requiring a permit can not be declared using a TDC.

11. Personal Exemptions

24-hour absence - $200 exemption 48-hour absence or more - $800 exemption

Indicate how long you have been outside of Canada. To be eligible for an exemption, you must have been away for the full length of time indicated. If you have been away for less than 24 hours, leave the "Exemption" box blank. You cannot combine exemptions.

Phone number Region Hours of operation

866-399-5887 Quebec and Atlantic residents Monday to Friday, 8 a.m. to 4 p.m. EST (except holidays)

800-842-7647 Ontario and United States residents Monday to Friday, 8:30 a.m. to 4:30 p.m. EST

866-496-3987 British Columbia, Alberta, Saskatchewan and Manitoba residents

Monday to Friday, 8 a.m. to 4 p.m. PST

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TDC TARIFF GUIDEç

Categories and Commodities Duty U.S. Other

GST (HST)* PST

Category 1 Carpeting Life jackets and belts Skates (ice and roller) Sleeping bags Textile articles (bedding, linen, towels, curtains)

0% 20% 5% ( * )

ü

Category 2 Clothing Footwear

0% 18% 5% ( * )

ü

Category 3 Basic groceries (non-taxable) Bread Cakes and pies Other baked goods (pkgs. of 6 or more) Canned food goods Dairy products (maximum $20) including: • Butter • Cheese • Ice cream • Cream • Eggs (maximum 2 dozen) • Yogurt Fish and seafood Fresh or frozen fruit and vegetables Fruit and vegetable juices (large containers) Meat fresh or frozen (maximum 20 kg) including: • Chicken (maximum 10 kg) • Turkey (1 whole or maximum 10 kg of parts) • Beef and other meats Medications Milk

0% 7% 0% ( ) NA

Category 4 Articles of plastic, rubber, steel, wood Auto parts Baby carriages Beauty aids, cosmetics and toiletries Bicycles and tricycles Canoes/rowboats Cookware (stainless steel) Electrical ranges Gas barbecues Golf clubs and balls Groceries (taxable) • Candy • Snack foods • Soft drinks Household batteries Lightbulbs and light fixtures Lubricating oils Luggage Pot pourri Refrigerators Speakers Sports and exercise equipment Sunglasses Televisions Tires Tools (electric handheld) Vacuum cleaners Watches (under $50) Miscellaneous goods not elsewhere specified

0% 8% 5% ( * )

ü

- Provincial Taxes will be collected on these categories where an agreement between the Federal and Provincial governments exists. (*) The Harmonized Sales Tax (HST) will be collected where an agreement exists.

Categories and Commodities Duty U.S. Other

GST (HST)* PST

Category 4 (cont'd) Candles Ceramic tableware (dishes) and kitchenware Cleansers and other cleaning preparations Coffeemakers Dishwashers Furniture Machinery for working wood (wood planer, tablesaw, chainsaw) Paints and varnishes Paper products Pet foods Photographic film Single use cameras Wallets and purses (leather)

0% 8% 5% ( * )

ü

Category 5 Audio and video cassette recorders Audio and video tapes Antiques (must exceed an age of 100 years) Breadmaker Calculators (electronic) Cameras, lenses and flashes Clothes dryers Compact discs Compact and video disc players Computers and related equipment • Display units • Keyboards • Modems • Printers • Scanners • Software (on CD-ROM, disk, tape) Curling irons Electric shavers Fax and answering machines Flashlights Glass and glassware Hair dryers Irons (clothes) Microwave ovens Motorcycle parts Rice cooker Sewing machines Telephones (Portable and cellular) Toasters Tools (pneumatic powered only) Toys Video cameras Video games and video game units

0% 0% 5% ( * )

ü

Category 6 PST Exempt Goods 0% 0% 5% NA

Category 7 Books**Category 8 Beer - per dozen** Category 9 Wine - per litre** Category 10 Liqueurs, Liquor - per litre** Category 11 Cigarettes - per pack of 20** Category 12 Tobacco - per 200 grams

** Values for these categories will be available

from your local CBSA office.