Fill in the customs declaration received from flight attendants legibly (in block letters), with a pen or a ball pen. Confirm that the information you supplied is true with your signature. In addition to customs declaration, you will also receive a visa declaration coded I-94. Please complete it accurately. Every passenger who is not a U.S. citizen is obliged to complete the first page of form I-94. Permanent residents in the U.S.A., holders of a Green Card or immigration visa are not obliged to complete the first page. Carefully read the instructions before you begin writing.
Flight attendants are ready to assist you and provide additional information. Submit both completed declarations, together with your passport(s), to the passport and customs inspectors.

Instructions for filling in the customs declaration:

1 Surname, first and second/middle name
2. Date of birth day/month/year
3. Number of accompanying family members
4. (a) Address in the U.S.A. (name of the hotel, final destination), (b) city, (c) state
5. Passport issued by (country)
6. Passport number
7. Country of permanent residence
8. Countries visited in the course of this journey before arriving in the U.S.A.
9. Airline/flight number or name of vessel
10. The main purpose of this journey is business -yes/no
11. I (we) import: (a) fruit, plants, food (b) insects: yes/no
(b) meat products, animals, animal products/venison – yes/no
 (c) pathogenic factors, cell cultures. snails – yes/no
 (d) samples of soil (or) I (we) stayed on a farm/pasture – yes/no
12. I was (we were) in close contact with farm animals (touching, grooming) – yes/no
13. I (we) bring currency or currency means worth USD 10 thousand or an equivalent of that amount in foreign currency (for definition of currency means see the reverse) – yes/no
14. I (we) own commercial products (products for sales, samples of products for canvassing or products not considered as personal) – yes/no
15. Permanent residents of the U.S.A. – total value of all products including commercial products purchased abroad (including gifts for other persons, excluding products mailed to the U.S.A.) and imported into the U.S.A. is: amount in USD
Visitors – total value of all products to be enduringly left in the U.S.A. including commercial products is: amount in USD

Please read the instruction on the reverse of this form. List in the appropriate box all products to declare.
I confirm herewith, that I have read the instruction on the reverse side of this form and my declaration is true and accurate. 

Place your signature (in a box marked with X) – after reading the supplementary explanations - below.

SUPPLEMENTARY EXPLANATIONS
All persons can be subject to an interrogation and examination (including inspection of property).
Illegal imports of restricted substances (drugs, chemicals, pharmaceuticals on prescription only and not accompanied with prescription etc.) irrespective of the amount, constitutes a violation of the law of the United States of America.

FARM AND ANIMAL PRODUCTS
In order to prevent the transfer of dangerous pests and forbidden animals, the imports of the following items shall be restricted: fruit, vegetables, plants, plant products, soil, meat, meat products, birds, snails and other live animals or animal products. Travellers who fail to declare all items of this kind to the customs or agricultural inspector shall be subject to punishment and the items may be confiscated.

CURRENCY AND MEANS OF CURRENCY

Import of currency or money is legal irrespective of the amount; however, a person who exports from or imports to the U.S.A. an amount exceeding USD 10 thousand (in U.S. currency or the equivalent of this amount in foreign currency, or both in total), in the form of coins, banknotes, traveller’s cheques or bearer securities such as money transfers, personal or bank cheques, shares or bonds, is legally obliged to declare this amount on the Customs Questionnaire USA No 4790. The passenger must complete such questionnaire even when some other person transfers the currency or means of currency for him/her. The failure to complete the questionnaire or declaration of incomplete amount of carried means of currency may result in confiscating the whole amount of currency and all securities as well as imposing an administrative penalty and/or criminal investigation.

GOODS
Passengers (who are not permanent residents of the U.S.A.) have to declare (in point 14) the total value of all goods intended for sale or to be left in the U.S.A. Such goods include all gifts, commercial products or samples (Exception: personal items such as clothes, jewellery, photo equipment, luggage etc. are duty free.)

Permanent residents of the U.S.A. must declare in point 14, the total value of all items purchased abroad. This includes commercial products and samples (irrespective of whether such products are new or used, dutiable or duty free, purchased, received as gifts or acquired in some other manner), including products purchased in duty free shops in the U.S.A. and abroad, which are in their possession at the moment of entering the United States. Items acquired in the course of this journey by way of mailing from other countries (excluding items purchase in overseas territories of the U.S.A. and in the Caribbean countries) are subject to duty at the moment of importing them into the U.S.A.

The employees of the Customs Office shall establish the amount of the customs duty. Permanent residents of the United States are usually entitled to duty free imports of goods with the total value of USD 400 if they are imported upon arrival; persons who are not permanent residents of the U.S.A. are usually entitled to duty free imports of goods with the total value of USD 100. The customs duty usually amounts to 10% on the first thousand of USD exceeding the above limits. If the value of all items declared in point 14 excludes 1400 USD per person. They should be listed in the table on the reverse of the Customs declaration, and their prices should be specified in USD (for gifts specify their actual value equal to the retail price. The items should be described with their common names and materials of which they are made. For example: men’s wool knitted sweater, a diamond ring of gold etc.
Have bills and receipts ready for the customs officer’s inspection and make them available upon his request. This will contribute to facilitating the customs inspection.

Commercial goods are products intended for sale, which support canvassing or other items not considered as personal items of the passenger.

All questions concerning items to declare or items on which duty is to be imposed should be directed to customs officers.

An instruction for completing the visa declaration:

Box number

1 Surname
2 Name
3 Birth date: day/month/year
4 Country of citizenship (e.g. POLAND)
5 Sex: man – MALE; woman - FEMALE
6 Passport number
7 Flight number
8 Country of residence (e.g. POLAND)
9 Point of departure for international journey (e.g. Kraków, Warszawa)
10 Place of issuing the visa (e.g. Kraków, Warszawa)
11 Date of issuing the visa: day/month/year
12 Address in the U.S.A.: house number, street
13 Address in the U.S.A.: city/town and state
14 Surname
15 Name
16 Date of birth: day/month/year
17 Country of citizenship (e.g. POLAND)