A link to the Portable Document Format (PDF) of this form is provided below. The content of the form is duplicated in HTML following the PDF link.
This form must be forwarded to CBSA at least two hours prior to the arrival of the train.
- 1. Name of rail company
- 2. Train number
- 3. Family name, given name
- 4. Date of birth (YYYY-MM-DD)
- 5. Citizenship
- 6. Residency
- 7. Alcohol (Yes/No)
- 8. Tobacco (Yes/No)
- 9. Currency or Monetary Instruments totalling CAN $10,000 or more (Yes/No)
- 10. Restricted or controlled goods (Yes/No)
- 11. Value of goods
- 12. Duration
- 13. Signature
I, (person in charge of train), hereby certify that I am the person in charge of train number (number), and the above names listed are presented to customs in accordance with subsection 11(3) of the Customs Act.
- Signature of person in charge of train
- Date of arrival
Instructions for completion
You must declare all goods that you are bringing or having shipped to Canada, that you purchased, received as gifts, or acquired in any manner while outside Canada, including goods purchased at duty free shops, whether or not you claim them as part of your exemption. If in doubt about any article, declare it.
A border services officer may examine your goods.
The Canada border Services Agency (CBSA) can seize any goods you do not declare, or any goods you falsely declare. You may also face prosecution.
Personal exemption information for Canadian residents may be found in the CBSA pamphlet "I Declare." Non-residents may obtain information on bringing personal goods into Canada from the booklet "Customs Infomation for Visitors to Canada and Seasonal Residents." Both publications are available at any CBSA office.
1. Name of rail company – Self explanatory
2. Train number – Self explanatory
3. Name – Name to be completed (last name, first name)
4. Date of birth – Provide date of birth (YYYY-MM-DD)
5. Citizenship – Provide country of citizenship
6. Residency – Provide country of residence
7. Alcohol (beer, liquor, wine, etc.) – If you have alcohol products, state the quantity and description (24 - 12 oz. beer, 40 oz. rye, etc.)
8. Tobacco (cigarettes, cigars, tobacco, etc.) – If you have tobacco products, state the quantity and description (1 carton cigarettes, 50 cigars, etc.)
9. Currency or monetary instruments totalling CAN $10,000 or more – Currency and monetary instruments totalling CAN $10,000 or greater must be reported to the CBSA. When checking the "yes" box, the appropriate Cross-Border Currency or Monetary Instruments Report form must be completed and handed in to the CBSA.
10. Restricted or controlled goods – Goods such as firearms, other weapons (such as mace, pepper spray, knives), drugs and articles made or derived from endangered species may be restricted or controlled, or may require a special admission permit. Should you have any of these goods, provide a brief description of the article (hand gun, knife, etc.)
11. Value of goods – Residents must declare all goods purchased, received or acquired while outside Canada. Non-residents must declare all goods to be left in Canada. Provide the total value of the goods being imported, in Canadian dollars.
12. Duration – Provide the length of time (in hours). Residents will provide the length of time spent outside Canada. Non-residents will provide the length of time they will stay in Canada.
13. Signature – Self explanatory
- Date modified: