| You are: | |
| Purpose of travel: | |
| VISITING DOMINICAN REPUBLIC - FLIGHT DETAILS |
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| Is your flight to the Dominican Republic direct or does it include a layover? | |
| Departure airport: | |
| Flight date: | |
| Airline company: | |
| Flight number (ensure you enter the flight number, not the confirmation number) | |
| Transit airport: | |
| Connecting flight date: | |
| Connecting airline company: | |
| Connecting flight number: | |
| Arrival airport in the Dominican Republic: | |
| Date of Arrival in the Dominican Republic: | |
| ACCOMMODATION IN DOMINICAN REPUBLIC |
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| How many days do you plan to stay in the country?: | |
| Accommodation Type: | |
| Name of hotel: | |
| Full address of accommodation: | |
| Province: | |
| Municipality (if known): | |
| Section (if known): | |
| Harbor: | |
| Destination country: | |
| Do you plan to practice one of the following sports activities during your stay:: | |
| DEPARTURE FROM THE DOMINICAN REPUBLIC |
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| Airport of departure from the Dominican Republic: | |
| Departure from the Dominican Republic: | |
| Flight number: | |
| Airline company: | |
| Destination country: | |
| Airport of final destination: | |
| PERSONAL INFORMATION: |
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| First names: | |
| Last names: | |
| Email address: | |
| Gender: | |
| Phone number (including country code): | |
| Date of birth: | |
| Country of birth: | |
| Home Address: | |
| City: | |
| Zip code / Postal code: | |
| Home Country: | |
| Passport Number: | |
| Passport issuing country: | |
| Civil status: | |
| Occupation: | |
| EXTRA VISITORS INFORMATION |
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| Are you travelling alone? | |
| What is your relationship with the other travel members: | |
| Number of additional visitors: | |
| ADDITIONAL VISITOR 1 |
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| First name: | |
| Last name: | |
| Date of birth: | |
| Country of birth: | |
| Gender: | |
| Passport Number: | |
| Passport issuing country: | |
| Civil status: | |
| Occupation: | |
| ADDITIONAL VISITOR 2 |
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| First name: | |
| Last name: | |
| Date of birth: | |
| Country of birth: | |
| Gender: | |
| Passport Number: | |
| Passport Issuing Country: | |
| Civil status: | |
| Occupation: | |
| ADDITIONAL VISITOR 3 |
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| First name: | |
| Last name: | |
| Date of birth: | |
| Country of birth: | |
| Passport Number: | |
| Gender: | |
| Passport Issuing Country: | |
| Civil status: | |
| Occupation: | |
| ADDITIONAL VISITOR 4 |
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| First name: | |
| Last name: | |
| Date of birth: | |
| Country of birth: | |
| Gender: | |
| Passport Number: | |
| Passport Issuing Country: | |
| Civil status: | |
| Occupation: | |
| ADDITIONAL VISITOR 5 |
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| First name: | |
| Last name: | |
| Date of birth: | |
| Country of birth: | |
| Gender: | |
| Passport Number: | |
| Passport Issuing Country: | |
| Civil status: | |
| Occupation: | |
| ADDITIONAL VISITOR 6 |
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| First name: | |
| Last name: | |
| Date of birth: | |
| Country of birth: | |
| Gender: | |
| Passport Number: | |
| Passport Issuing Country: | |
| Civil status: | |
| Occupation: | |
| ENTRY INFORMATION |
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| Are you filling in the Customs Form on behalf of a third party? | |
| Names: | |
| Relationship: | |
| Are you bringing currency or other payment instrument exceeding USD 10,000? | |
| Amount: | |
| Type of currency (e.g. EUR, USD, GBP): | |
| What is the origin of the securities: | |
| Are you the owner of the values? | |
| Sender first names: | |
| Sender last names: | |
| Receiver first names: | |
| Receiver last names: | |
| Relationship between traveler and sender/receiver: | |
| Purpose or destiny of the values: | |
| Are you bringing with you (including in the luggage or any other possessions of any member of your travel group) live animal(s) and/or plants, and/or food products? | |
| Are you bringing with you (including in the luggage or any other possessions of any member of your travel group) goods subject of tax payment? | |
