Customs Declaration fake werner 39 CFR 122.27, 148.12, 1468.12, 148.100, 148.111, 1498 31 CFR S36 OMB WO 1651-0005, Each arriving traveler or responsible famity member must provide the fotiowing information (only ONE written declaration per family is required). The term “family” is defined as “members of a family residing in the same household who are related by blood, marriage, domestic relationship, or adoption.” | apg EPSTEIN First (Gwen) TTEFFREY Midde CDWARD Boutn cate month Ol day 2O YearS 3 Number of Family members traveling with you © (a) U.S. Street Address (hotei name/destination 4 EAST V\st STReeT wcty NEW YoRK : (©) State A)Y EE country of Residence Vir JU | Sromterg in FRA, KSA trip prior to U.S. arrival Bf Aitine Fight No. or Vessel Name f\) 2. | ZTE BG the primary purpose of this trip is business: Yes NoX | am (We are) bringing 5 Yes No Yes No Yes No Yes No Yes No bey | am (We are) carrying - 5 " ’ over $10,000 U.S. or foreign eMpivalent: Yes Nox (see definition of monetary in: st] | have (We have) commercial (articles for sale. samples used for so or goods that are not considered p RESIDENTS —the total vaiue of all \/we have purchased or acquired but not items mailed to the U.S.) bringing to the U.S. is: VISITORS—the total value of all a in the U.S., i i Read the instructions on the back of tt items you must deciare. x ae ~ tf Joo Ome (mentn/dew'vee) CBP Form 60598 (04/14) form. Space is provided to list all the EFTA00313939