Online E-Ticket Application form for Dominican Republic

MIGRATORY INFORMATION

Fields marked with a red asterisk are required (*)
ARE YOU LODGING IN A PRIVATE RENTAL? (E.G : AIRBNB)ARE YOU GOING TO STAY AT A HOTEL?FAMILY/FRIENDSOWN HOUSEEMBARKATION (SHIP/FERRY)TRANSIT
ADDRESS AT THE DOMINICAN REPUBLIC
CITY*
STREET AND NUMBER*
HOTEL NAME*
HARBORS*
COUNTRY OF DESTINATION*
EMBARKATION PORT*
Departure Airport
DISEMBARKATION PORT*
Arrival Airport
AIRLINE NAME*
FLIGHT DATE*

MonthDayYear
FLIGHT NUMBER*
TRAVEL PURPOSE*
DAYS OF STAYING

CUSTOMS INFORMATION

Fields marked with a red asterisk are required (*)
SUBMIT DEPARTURE E TICKET
DO YOU BRING OR BRING WITH YOU OR IN YOUR LUGGAGE (S), YOU AND / OR YOUR FAMILY MEMBERS, CURRENCY VALUES OR ANOTHER PAYMENT INSTRUMENT, AN AMOUNT IN EXCESS OF USD $ 10,000.00 OR ITS EQUIVALENT IN ANOTHER ( S) TYPE (S) OF CURRENCY (S)?*
AMMOUNT*
DECLARE ORIGIN OF THE SECURITIES*
ARE YOU THE OWNER OF THE VALUES YOU CARRY?*
SENDER NAME*
SENDER LAST NAME*
RECEIVER NAME*
RECEIVER LAST NAME*
RELATIONSHIP WITH SENDER OR RECEIVER*
USE OR DESTINY OF THE MONEY OR VALUES *
DO YOU BRING WITH YOU OR IN YOUR LUGGAGE LIVE ANIMALS, PLANTS OR FOOD PRODUCTS?*
DO YOU BRING WITH YOU OR IN YOUR BAGGAGE GOODS SUBJECT TO TAX PAYMENT?*
NOTE: THE PASSENGER MAY BRING GOODS OR OBJECTS FOR GIFTS FOR A TOTAL VALUE OF UP TO USD $ 500.00 (FIVE HUNDRED DOLLARS). THIS EASE CAN ONLY BE USED AND APPLIED ONCE EVERY (3) MONTHS.
NOTE: THE PRESENTATION OF THIS DECLARATION IS MANDATORY FOR ALL PASSENGERS WHO LEAVE OR ENTER THE DR. FOR MINORS, THIS FORM MUST BE COMPLETED AND SIGNED BY THE RESPONSIBLE ADULT. THE DECLARATION OF INFORMATION FAULTS OR INCOMPLETES MAY ORIGINATE PENALTIES SUCH AS SEIZURES OF SECURITIES, OF GOODS AND DEPRIVATION OF FREEDOM, ACCORDING TO ARTICLE 200 OF LAW 3489, OF CUSTOMS REGIME, AND ARTICLE 4 OF LAW NO. 155-17 AGAINST WASHING ASSETS. THIS DECLARATION MUST BE SIGNED BY THE PASSENGER WHERE IT IS INDICATED
*
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E-Ticket Application
$39.00

Total

$0.00

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E-Ticket Application