Customs declaration
Full name_________________________________________________
Citizenship________________________________________________
Arriving from______________________________________________
Purpose of visit_____________________________________________
( business, tourism, private, etc. )
My luggage (including hand luggage)submitted for Customs inspections
Consists of_______________________________________ pieces.
With me and in my luggage I have:
Weapons of all descriptions and ammunition_____________
Narcotics and appliances for the use thereof______________
Antiques and objects of art ( paintings, drawings, icons,
Sculptures, etc. ) ____________________________________
Ukrainian hrivnyas, Ukrainian State Loan bonds, Ukrainian
Lottery tickets______________________________________
Currency other than Ukrainian hrivnyas ( bank notes, coins,
Bills ), payment vouchers ( cheques, bills, letters of credit, etc. ),
Securities ( shares, bonds, etc. ) in foreign currencies, precious
Metals ( gold, silver, platinum, metals of platinum group ) in any
Form or condition, crude and processed natural precious stones
( diamonds, brilliants, rubies, emeralds, sapphires and pearls ),
Jewelry and other articles made of precious metals and precious
Stones, and scrap thereof, as well as property papers:
| Description | Amount/Quantity | For official use |
| | In figures | In words | |
| | | | |
| | | | |
Ukrainian hrivnyas, other currency, payment vouchers, valuables
And any objects belonging to other persons.
I am aware that, in addition to the objects listed in the Customs Declaration, I must submit for inspection: printed matter, manuscripts,
Films, sound recordings, postage stamps, graphics, etc. , plants, fruits,
Seeds, live animals and birds, as well as raw foodstuffs of animal origin
And slaughtered fowl.
I also declare that my luggage sent separately consists of____pieces.
(Date) _____200__ Owner of luggage_______________(signed)