CURRENCIES DECLARATION FORM

ONLY FOR TRAVELERS OR SHIPPERS CARRYING OR IMPORTING/EXPORTING THE FOLLOWING:
(A) PHILIPPINE PESOS IN EXCESS OF PHP50,000; AND/OR (B) FOREIGN CURRENCIES OR OTHER FOREIGN
CURRENCY-DENOMINDATED BEARER MONETARY INSTRUMENTS IN EXCESS OF USD10,000 OR ITS EQUIVALENT

REPUBLIC OF THE PHILIPPINES


Write in capital letters. Do not abbreviate. Write N/A if not applicable. Tick as appropriate
PERSON TRANSFERRING CURRENCY OR MONETARY INSTRUMENT
PART I For a person transferring currencies and other monetary instruments into/out of the Philippines in excess of the thresholds.
8. PERMANENT ADDRESS IN THE PHILIPPINES OR ABROAD:
9. RESIDENCE/ADDRESS WHILE IN THE PHILIPPINES:
TRANSFERRING ON BEHALF OF ANOTHER PERSON/ENTITY
PART II If currencies and other monetary instruments are not owned by declarant and are being transferred on behalf of another person/entity.
A. OWNER OF CURRENCIES OR MONETARY INSTRUMENTS
B. RECIPIENT OF CURRENCIES OR MONETARY INSTRUMENTS
PART III CURRENCY OR MONETARY INSTRUMENT INFORMATION
Currency Monetary Instrument Country Amount in words Amount



PART IV REQUIRED INFORMATION BY THE BOC AND AMLC - OTHER TRAVEL DETAILS
Accomplish “26.A” if physically transferred by a person OR “26.B” if shipped
PART V
I HEREBY CERTIFY UNDER PENALTY OF LAW THAT THIS DECLARATION IS TRUE AND CORRECT