CBP Form 5129 Crew Member's Declaration 2022-2026

10 C. R. For importer s right to protest or Government s right to re-determine this amount see section 514 Tariff Act of 1930 as amended. CBP Form 5129 12/18 Page 1 of 2 1. OMB Control Number 1651-0021 Expiration Date 11/30/2020 DEPARTMENT OF HOMELAND SECURITY 1. Crew Member s Article No* U*S* Customs and Border Protection CREW MEMBER S DECLARATION Nr A0000000 19 CFR 4. 7 4. 7a 4. 81 122. 83 122. 84 148. 61-67 2. Carrier Vessel Flag Name 5. Crew Member s Name 6. Rank 3. Date of Arrival 4. Port of Arrival 7. Date of Birth INSTRUCTIONS List all articles obtained abroad and prices paid or fair value if not purchased* Include serial number with all articles subject to registration such as cameras radios etc* 8. Address 9. Answer Each Question A. Are you carrying any fruits plants meats other plant or animal products birds snails or other live organisms of any kind Yes B. Have you been on a farm or ranch outside the U*S*A. in the last 30 days No instruments such as coin currency traveler s checks money orders or negotiable instruments in bearer form If yes you must file a report on FinCen 105 Quantity and Description of Goods Cost or Value of Gifts etc* List separately articles intended for sale barter exchange or carried by you as an accommodation for someone else. See additional instructions and information on reverse. I. To be filled in by Crew Member List articles to remain on board separately from those articles to be landed in the United States. II. For CBP Officer s Use Tariff Description Value I certify that the above statement is a just true and complete account of all articles of foreign origin for which written declaration and entry are required when landed in the United States defined on reverse side and I also certify that this statement is a just true and complete declaration of all such articles which I am landing in the United States. 10. CBP Officer Accepting Entry 11. Signature of Crew Member RECEIPT FOR DUTY AND RELEASE SLIP Name Port Duty TOTAL 12. Date Carrier Repeat List of Articles to Be Landed include serial numbers when appropriate Rate Date For CBP Officer s Use Articles listed at left have been examined and passed Pieces of Baggage Released The CBP officer accepting the declaration and entry shall draw lines through unused spaces on receipt with ink. Notice Liquidation of amount of duties and taxes if any due on this entry is effective on date of payment of this amount Section 159. This declaration must be legibly prepared using pen typewriter or other permanent method. This declaration is required for all articles which are to be landed by a crew member including any person traveling on board a vessel vehicle or aircraft engaged in international traffic who is returning from a trip on which the person was employed as a crew member. 2. Include serial number with all articles subject to registration such as cameras radios etc* List articles to remain on board separately from those articles to be landed in the United States. List separately articles intended for sale barter exchange or carried by you as an accommodation for someone else.