Form Approved  

O.M.B. No. 1515-0002 

See back of form for Paper- work Reduction Act Notice.

Owner or Operator

Flight No.

Date

Marks of

Nationality and Registration

Arrival at

Departure from

(Place)

DEPARTMENT OF THE TREASURY 
United States Customs Service

G E N E R A L  D E C L A R A T I O N 

(Outward/Inward) 

AGRICULTURE, CUSTOMS, IMMIGRATION, AND PUBLIC HEALTH 

19 CFR 122.43,122.52,122.54,122.73,122.144

(Place)

(mm/dd/yyyy)

(This is a mandatory field)

DEPARTMENT OF THE TREASURY
United States Customs Service General Declaration 
(Outward/Inward)
Agriculture, Customs, Immigration, and Public Health. 19 CFR 122.43,
122.52,
122.54,
122.73,
122.144. Form Approved O M B Number 15 15-00 02, See back of form for Paperwork Reduction Act Notice.

Customs Form 7507 (121696)

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