Customs Act 1901 - CEO Instrument of Approval No. 42 of 2005

COMMONWEALTH OF AUSTRALIA

CEO Instrument of Approval No. 42 of 2005

Customs Act 1901

I, LIONEL BARRIE WOODWARD, Chief Executive Officer of Customs, under section 4A of the Customs Act 1901 (the Act) and regulation 41 of the Customs Regulations 1926 (the Regulations), approve the attached "Unaccompanied Personal Effects Statement" form (No. B534 (6/00) French) as an approved form for the purpose of providing, in the French language, information required under section 71AAAB of the Act and regulation 41 of the Regulations in relation to goods that are the unaccompanied personal or household effects of a passenger.

This instrument commences on the day after it is registered.

Dated: 24 August 2005

L B WOODWARD

Chief Executive Officer of Customs

• Ceci est un document qui engage votre responsabilité au regard de la loi et qui pourra être utilisé comme preuve en cas de litige

• Cette déclaration doit être complétée en anglais (en caractères d’imprimerie) et toute modification devra être désignée par les intiales du déclarant.

MISE EN GARDE

Ne pas transporter de drogues. Les délits concernant la drogue sont sévèrement punis en Australie. Toute déclaration erronée, trompeuse ou incomplète aux services de la douane constitue un délit sérieux, qui sera puni sévèrement, y compris par la confiscation des articles en question.

AVIS

Les dispositions légales destinées à éviter toute atteinte à la vie privée des personnes (Privacy Act de 1988), stipulent, qu’il est de notre devoir de vous informer à la fois des raisons pour lesquelles nous recueillons ces informations, de la façon dont celles-ci pourront être utilisées et, de ce qui vous oblige à nous fournir ces renseignements. Ces informations nous permettent de nous assurer que les voyageurs respectent la réglementation mise en place par les Services de Douane, de Quarantaine et de la Santé, ainsi que la législation concernant la protection des animaux sauvages et les mouvements de fonds et valeurs monétaires. Selon les dispositions légales concernant; les restrictions douanières (réglementation de 1901); la quarantaine (réglementation de 1908); la protection des animaux sauvages (réglementation de 1982 concernant les exportations comme les importations) et; les transactions et mouvements financiers (réglementation de 1988), nous sommes obligés de recueillir ces informations. Les Services de la douane ont de même, besoin de ces renseignements afin de pouvoir calculer le montant des droits et taxes douanières à percevoir. Si vous ne répondez pas à certaines des questions contenues dans ce formulaire, elles vous seront posées directement par un agent de la douane ou des services de la quarantaine. Les Services australiens de la douane et de la quarantaine ne sont pas autorisés à divulger ces informations ou toute autre information que vous leur fournirez, sauf si une autorisation ou une demande expresse leur a été faite dans ce sens pour des raisons de droit.

<table cellspacing="0" cellpadding="0" style="width:544.3pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr><td style="width:534.7pt; padding:2.15pt 3.8pt; vertical-align:top; background-color:#d9dadb"><p style="margin-bottom:4pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Veuillez fournir les renseignements suivants</span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="12" style="width:369.95pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Prénoms</span></p></td><td style="width:152.65pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Nom de famille</span></p></td></tr><tr style="height:1pt"><td colspan="12" style="width:369.95pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Adresse et numéro de téléphone du lieu de résidence actuel ou envisagé en Australie</span></p></td><td style="width:152.65pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Date de naissance</span></p></td></tr><tr style="height:1pt"><td style="width:20.7pt; border-top:1pt solid #000000; border-left:1pt solid #000000; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt 1.45pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:7pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Sexe</span></p></td><td style="width:10.5pt; border-top:1pt solid #000000; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:37.25pt; border-top:1pt solid #000000; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Masculin</span></p></td><td style="width:10.5pt; border-top:1pt solid #000000; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td colspan="3" style="width:37.65pt; border-top:1pt solid #000000; border-right:1pt solid #000000; border-bottom:1pt solid #000000; padding:1.45pt 2.4pt 1.45pt 2.9pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Féminin</span></p></td><td colspan="4" style="width:176pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Numéro de passeport</span></p></td><td colspan="2" style="width:201pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Lieu de délivrance </span><span style="font-family:'Times New Roman', serif; font-style:italic">(Pays)</span></p></td></tr><tr style="height:1pt"><td colspan="5" style="width:111.7pt; border-top:1pt solid #000000; border-left:1pt solid #000000; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt 1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Personnes concernées par cette déclaration:</span></p></td><td style="width:18.3pt; border-top:1pt solid #000000; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td colspan="2" style="width:50.95pt; border-top:1pt solid #000000; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Moi-même</span></p></td><td style="width:10.4pt; border-top:1pt solid #000000; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:45.05pt; border-top:1pt solid #000000; border-right:1pt solid #000000; border-bottom:1pt solid #000000; padding:1.45pt 2.4pt 1.45pt 2.9pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Conjoint</span></p></td><td colspan="3" style="width:263pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Nom du conjoint</span></p></td></tr><tr style="height:1pt"><td colspan="10" style="width:259.6pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-right:133.05pt; margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Numéro de passeport du conjoint</span></p></td><td colspan="3" style="width:263pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Nombre d’enfants de moins de 18 ans</span></p></td></tr><tr style="height:0pt"><td style="width:26.45pt"></td><td style="width:16.3pt"></td><td style="width:43.05pt"></td><td style="width:16.3pt"></td><td style="width:15.35pt"></td><td style="width:24.1pt"></td><td style="width:4pt"></td><td style="width:52.75pt"></td><td style="width:16.3pt"></td><td style="width:50.85pt"></td><td style="width:62pt"></td><td style="width:48.35pt"></td><td style="width:158.4pt"></td></tr></tbody></table><p style="margin-top:3pt; margin-bottom:4pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Arrivée en Australie (effective ou prévue)</span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="2" style="width:368.4pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:7pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">A bord de</span><span style="font-family:'Times New Roman', serif; font-style:italic"> (référence du vol ou bateau)</span></p></td><td style="width:170.1pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:7pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">A </span><span style="font-family:'Times New Roman', serif; font-style:italic">(aéroport ou port de débarquement)</span></p></td></tr><tr style="height:1pt"><td style="width:203.55pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:7pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Date d’arrivée </span><span style="font-family:'Times New Roman', serif; font-style:italic">(effective ou prévue)</span></p></td><td colspan="2" style="width:334.95pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:7pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Lieu d’embarquement </span><span style="font-family:'Times New Roman', serif; font-style:italic">(Pays)</span></p></td></tr><tr style="height:0pt"><td style="width:203.3pt"></td><td style="width:158.95pt"></td><td style="width:171.95pt"></td></tr></tbody></table><p style="margin-top:2pt; margin-bottom:2pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Pour les résidents retournant en Australie uniquement</span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:338.75pt; border-right:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Autres pays visités</span></p></td><td style="width:199.5pt; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-right:59.8pt; margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Période d’absence hors du territoire australien</span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">L’acheminement de mes effets personnels en Australie s’effectue</span></p><table cellspacing="0" cellpadding="0" style="width:534.55pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:14.75pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td colspan="2" style="width:83.65pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Par voie postale; ou</span></p></td><td style="width:10.5pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:84.75pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Par voie aérienne; ou</span></p></td><td style="width:0.95pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.65pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:73.2pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Par voie maritime</span></p></td><td style="width:209.7pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-style:italic">(si ces effets sont acheminés par voie aérienne ou maritime, veuillez compléter la section suivante)</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="width:21.1pt; border-right:1pt solid #000000; padding:1.45pt 2.4pt 1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Le(s)</span></p></td><td colspan="3" style="width:184.15pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">(nombre de colis/pacquets)</span></p></td><td style="width:0.95pt; border-left:1pt solid #000000; padding:1.45pt 2.9pt 1.45pt 2.4pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="width:305.15pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">expédiés à mon attention (sont arrivés ou doivent arriver):</span></p></td></tr><tr style="height:0pt"><td style="width:20.55pt"></td><td style="width:6.35pt"></td><td style="width:83.1pt"></td><td style="width:16.3pt"></td><td style="width:90.55pt"></td><td style="width:6.75pt"></td><td style="width:16.45pt"></td><td style="width:79pt"></td><td style="width:215.5pt"></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:4pt"><span style="font-family:'Times New Roman', serif"></span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:151.25pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Par </span><span style="font-family:'Times New Roman', serif; font-style:italic">(référence du vol ou bateau)</span></p></td><td colspan="2" style="width:168.6pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">A </span><span style="font-family:'Times New Roman', serif; font-style:italic">(aéroport ou port d’arrivée)</span></p></td><td style="width:210.85pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Date d’arrivée </span><span style="font-family:'Times New Roman', serif; font-style:italic">(effective ou prévue)</span></p></td></tr><tr style="height:1pt"><td style="width:151.25pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Référence du container</span></p></td><td style="width:151.5pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Bon d’expédition </span><span style="font-family:'Times New Roman', serif; font-style:italic">(ou police de chargement par air ou mer)</span></p></td><td colspan="2" style="width:227.95pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Nom de l’organisation locale chargée de réceptionner vos effets personnels</span></p></td></tr><tr style="height:0pt"><td style="width:153.05pt"></td><td style="width:153.65pt"></td><td style="width:16.55pt"></td><td style="width:210.95pt"></td></tr></tbody></table><p style="margin-top:3pt; margin-bottom:3pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Dédouanement de vos effets personnels</span></p><p style="margin-bottom:12pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Vous pouvez dédouaner vos effets personnels vous-même ou engager un courtier accrédité en douanes pour éffectuer ce dédouanement à votre place ou vous pouvez désigner une tierce personne pour vous répresenter (par example membre de votre famille ou ami). Si vous souhaitez désigner une personne à votre place vous devez fournir les renseignements demandés dans l’emplacement qui suit</span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:238.45pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Nom de famille</span></p></td><td colspan="2" style="width:299.8pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Prénoms</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="width:345.5pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Adresse</span></p></td><td style="width:192.75pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-style:italic">Numéro de téléphone</span></p></td></tr><tr style="height:0pt"><td style="width:237.3pt"></td><td style="width:103.5pt"></td><td style="width:193.4pt"></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:6pt"><span style="font-family:'Times New Roman', serif"></span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="padding:1.45pt 2.9pt 1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="5" style="width:532.5pt; padding:1.45pt 2.9pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:10pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Votre représentant devra présenter lors du dédouanement de vos effets, l’une des pièces d’identité suivantes</span></p></td><td style="width:0.6pt; padding:1.45pt 2.4pt 1.45pt 2.9pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="border-right:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:122.1pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Numéro de permis de conduire</span></p></td><td style="width:121pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Lieu de délivrance</span></p></td><td style="width:23.1pt; border-right:1pt solid #000000; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Ou</span></p></td><td style="width:121.75pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Numéro de passeport</span></p></td><td style="width:121.35pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Lieu de délivrance </span><span style="font-family:'Times New Roman', serif; font-style:italic">(Pays)</span></p></td><td style="width:0.6pt; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="padding:1.45pt 2.9pt 1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:122.1pt; border-top:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:121pt; border-top:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:23.1pt; padding:1.45pt 2.9pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:121.75pt; padding:1.45pt 2.9pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:121.35pt; padding:1.45pt 2.9pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:0.6pt; padding:1.45pt 2.4pt 1.45pt 2.9pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table><p style="margin-top:3pt; margin-bottom:5pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Déclaration</span></p><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold; font-style:italic">Je soussigné déclare que les renseignements fournis dans ce formulaire sont, dans les limites de mon savoir, véridiques et corrects.</span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:427.5pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:15pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Signature du propriétaire</span></p></td><td style="width:95.1pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:15pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Date</span></p></td></tr><tr style="height:1pt"><td style="width:427.5pt; border-top:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:95.1pt; border-top:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">B534 (6/00) FRENCH</span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"></p></td></tr></tbody></table>

Important

Vous devez répondre à chacune des questions ci-dessous en cochant les options correspondantres de la façon suivante (). Si vous répondez OUI à l’une des questions figurant dans les sections trois à huit ou, si vous avez des doutes sur la nécessité de déclarer un ou plusieurs articles faisant partie de vos effets personnels, nous vous conseillons de fournir des renseignements complémentaires dans les espaces figurant en- dessous de chacune de ces questions ou dans un document annexe si l’espace fourni est insuffisant. Les effets non-accompagnés peuvent être inspectés. Veuillez vous assurer que vous êtes en mesure de fournir les clefs nécessaires pour ouvrir ces bagages lors du dédouanement.

<table cellspacing="0" cellpadding="0" style="width:544.3pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr><td style="width:534.7pt; padding:2.15pt 3.8pt; vertical-align:top; background-color:#d9dadb"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="8" style="width:251.75pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:4pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Section Un</span></p><p style="margin-bottom:3pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Êtes-vous venu ou venez-vous en Australie en vue de</span></p></td><td colspan="3" style="width:210.85pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:54.2pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:12.1pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td colspan="5" style="width:198.15pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:10pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">faire du tourisme uniquement</span></p></td><td colspan="2" style="width:29.9pt; border-right:1pt solid #000000; padding:2.9pt 2.4pt 2.9pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Wingdings 3', serif"></span></p></td><td colspan="3" style="width:210.85pt; border:1pt solid #000000; padding:2.9pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:10pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Veuillez Indiquer la durée de votre séjour</span></p></td><td colspan="2" style="width:54.2pt; border-left:1pt solid #000000; padding:2.9pt 2.9pt 2.9pt 2.4pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:12.1pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="5" rowspan="2" style="width:198.15pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">de prendre résidence temporaire en Australie uniquement?</span></p></td><td colspan="2" style="width:29.9pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="width:210.85pt; border-top:1pt solid #000000; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:54.2pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:12.1pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td colspan="2" style="width:29.9pt; border-right:1pt solid #000000; padding:2.9pt 2.4pt 2.9pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Wingdings 3', serif"></span></p></td><td colspan="3" style="width:210.85pt; border:1pt solid #000000; padding:2.9pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:10pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Veuillez Indiquer la durée de votre séjour</span></p></td><td colspan="2" style="width:54.2pt; border-left:1pt solid #000000; padding:2.9pt 2.9pt 2.9pt 2.4pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:12.1pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td colspan="12" style="width:510.5pt; padding:2.9pt; vertical-align:bottom"><p style="margin-top:1pt; margin-right:26.45pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">de reprendre résidence permanente en Australie (si vous avez temporairement quitté l’Australie depuis l’acquisition du droit de résidence ou si vous êtes citoyen australien et que vous rentrez en Australie à la suite d'une absence)?</span></p></td></tr><tr style="height:1pt"><td style="width:12.1pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td colspan="10" style="width:450.5pt; padding:2.9pt; vertical-align:middle"><p style="margin-top:1pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">de prendre pour la première fois résidence permanente en Australie selon vos droits?</span></p></td><td colspan="2" style="width:54.2pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:12.1pt; border-bottom:0.75pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td colspan="10" style="width:450.5pt; border-bottom:0.75pt solid #000000; padding:2.9pt; vertical-align:middle"><p style="margin-top:1pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">retourner provisoirement en Australie (si vous êtes citoyen australien résidant à l’étranger)?</span></p></td><td colspan="2" style="width:54.2pt; border-bottom:0.75pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="9" style="width:371.2pt; border-top:2.25pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Section Deux</span></p><p style="margin-bottom:4pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Avez-vous emballé vos effets vous-même?</span></p></td><td style="width:2.3pt; border-top:2.25pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:143pt; border-top:2.25pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="border-top:0.75pt solid #000000; vertical-align:top"></td></tr><tr style="height:1pt"><td colspan="2" style="width:14.45pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:18.7pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:18.8pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:140.6pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:6.05pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:143.6pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.3pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:143pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="vertical-align:top"></td></tr><tr style="height:1pt"><td colspan="2" style="width:14.45pt; padding:2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:18.7pt; padding:2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td><td style="width:18.8pt; border-right:1pt solid #000000; padding:2.9pt 2.4pt 2.9pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Wingdings 3', serif"></span></p></td><td colspan="8" style="width:458.75pt; border:1pt solid #000000; padding:2.9pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:10pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si vous répondez non, nom de la personne ayant emballé ces effets</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:1pt"><td colspan="12" style="width:528.1pt; padding:2.9pt; vertical-align:middle"><p style="margin-top:5pt; margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Avez-vous complète connnaissance du contenu des colis/bagages en question?</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:1pt"><td colspan="2" style="width:14.45pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:18.7pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:18.8pt; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:140.6pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:6.05pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:143.6pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.3pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:143pt; border-bottom:1pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="vertical-align:top"></td></tr><tr style="height:1pt"><td colspan="2" style="width:14.45pt; padding:2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:18.7pt; padding:2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td><td style="width:18.8pt; border-right:1pt solid #000000; padding:2.9pt 2.4pt 2.9pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Wingdings 3', serif"></span></p></td><td colspan="8" style="width:458.75pt; border:1pt solid #000000; padding:2.9pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si vous répondez non, veuillez expliquer pourquoi</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:1pt"><td colspan="12" style="width:528.1pt; padding:2.9pt; vertical-align:middle"><p style="margin-top:5pt; margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Ces colis/bagages sont-ils susceptibles de contenir des effets ou articles appartenant à des tiers, ou à l’une ou plusieurs des personnes qui vous ont accompagné en Australie?</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:1pt"><td colspan="2" style="width:14.45pt; padding:2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:18.7pt; padding:2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:18.8pt; border-right:1pt solid #000000; padding:2.9pt 2.4pt 2.9pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Wingdings 3', serif"></span></p></td><td style="width:140.6pt; border:1pt solid #000000; padding:2.9pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Nom</span></p></td><td colspan="2" style="width:6.05pt; border-right:1pt solid #000000; border-left:1pt solid #000000; padding:2.9pt 2.4pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:143.6pt; border:1pt solid #000000; padding:2.9pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Numéro de passeport</span></p></td><td style="width:2.3pt; border-right:1pt solid #000000; border-left:1pt solid #000000; padding:2.9pt 2.4pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:143pt; border:1pt solid #000000; padding:2.9pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Relation que vous avez avec cette personne</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:1pt"><td colspan="2" style="width:14.45pt; border-bottom:2.25pt solid #000000; padding:2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:18.7pt; border-bottom:2.25pt solid #000000; padding:2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td><td style="width:18.8pt; border-bottom:2.25pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:140.6pt; border-top:1pt solid #000000; border-bottom:2.25pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:6.05pt; border-bottom:2.25pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:143.6pt; border-top:1pt solid #000000; border-bottom:2.25pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.3pt; border-bottom:2.25pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="width:143pt; border-top:1pt solid #000000; border-bottom:2.25pt solid #000000; padding:2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="vertical-align:top"></td></tr><tr style="height:0pt"><td style="width:17.9pt"></td><td style="width:2.35pt"></td><td style="width:24.5pt"></td><td style="width:24.6pt"></td><td style="width:146.4pt"></td><td style="width:6.1pt"></td><td style="width:5.75pt"></td><td style="width:29.95pt"></td><td style="width:119.45pt"></td><td style="width:8.1pt"></td><td style="width:89.1pt"></td><td style="width:59.7pt"></td><td style="width:0.3pt"></td></tr></tbody></table><p style="margin-top:2pt; margin-bottom:3pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Section Trois</span></p><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Vos effets/bagages non-accompagnés contiennent-ils des articles prohibés tels que:</span></p><p style="margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Drogues de toute nature </span><span style="font-family:'Times New Roman', serif">(y compris, mais sans restriction) </span><span style="font-family:'Times New Roman', serif; font-style:italic">DHEA, narcotiques, hallucinogènes, amphétamines, barbituriques, tranquillisants, steroides ou substances destinées à accroître la performance sportive?</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:11.7pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:20.85pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:15.1pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:476.6pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td style="width:11.7pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:20.85pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.1pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:476.6pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:541.65pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:10pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si vous répondez oui, veuillez fournir une liste des substances en question</span></p></td></tr></tbody></table><p style="margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Armes </span><span style="font-family:'Times New Roman', serif">(y compris, mais sans restriction): </span><span style="font-family:'Times New Roman', serif; font-weight:bold">armes à feu ou éléments d’armes à feu </span><span style="font-family:'Times New Roman', serif; font-style:italic">(y compris les pistolets et fusils à air), munitions, répliques d’armes à feu, couteaux à lames à ressort et pompe, poignards, coup de poing américain et armes utilisés pour les arts martiaux.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:11.25pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:22.05pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:13.4pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:477.55pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td style="width:11.25pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.05pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.4pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:477.55pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:541.65pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:10pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si vous répondez oui, veuillez fournir une liste des objets en question</span></p></td></tr></tbody></table><p style="margin-top:3pt; margin-bottom:4pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Articles manufacturés à partir de peaux ou parties d’animaux et formes de vie sauvage </span><span style="font-family:'Times New Roman', serif">(y compris, mais sans restriction): r</span><span style="font-family:'Times New Roman', serif; font-style:italic">eptiles/serpents, éléphants, rhinocéros, membres de la famille des félins, baleines, dauphins, zèbres, antilopes, cervidés, ou corail.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:11pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:21.8pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:13.9pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:477.3pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td style="width:11pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.8pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.9pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:477.3pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:541.4pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:7pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si vous répondez oui, veuillez fournir une liste des objets en question</span></p></td></tr></tbody></table><p style="margin-top:3pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Du </span><span style="font-family:'Times New Roman', serif; font-weight:bold">matériel susceptible d’offenser </span><span style="font-family:'Times New Roman', serif">d'autre adultes considérés comme raisonnables. </span><span style="font-family:'Times New Roman', serif; font-style:italic">Ceci (y</span><span style="font-family:'Times New Roman', serif"> compris, mais sans restriction) du </span><span style="font-family:'Times New Roman', serif; font-weight:bold">matériel pornographique </span><span style="font-family:'Times New Roman', serif; font-style:italic">exploitant des enfants, du matériel pouvant servir à abuser de juvéniles, et tout matériel susceptible de promouvoir, d’inciter ou d’améner à la violence, à des délits ou crimes de violente nature, à l’usage de drogues, ou à tout conduite sexuelle condammnable (y compris d’ordre bestial).</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:10.75pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:29.7pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:11.95pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:473.25pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:543.05pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:12pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si vous répondez oui, veuillez fournir une liste du matériel en question</span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:7pt"></p></td></tr></tbody></table>

<table cellspacing="0" cellpadding="0" style="width:544.3pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr><td style="width:534.7pt; padding:2.15pt 3.8pt; vertical-align:top; background-color:#d9dadb"><p style="margin-top:2pt; margin-bottom:2pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Je soussigné déclare que les renseignements fournis dans ce formulaire sont, dans les limites de mon savoir, véridiques et corrects; avoir compris le sens des questions posées dans ce formulaire et y avoir répondu de façon véridique et correcte.</span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:438.7pt; border-right:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:4pt; margin-bottom:15pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Signature du propriétaire</span></p></td><td style="width:98.35pt; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:4pt; margin-bottom:15pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Date</span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"></p></td></tr></tbody></table>

<table cellspacing="0" cellpadding="0" style="width:544.3pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr><td style="width:534.7pt; padding:2.15pt 3.8pt; vertical-align:top; background-color:#d9dadb"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p><p style="margin-bottom:0pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Section Quatre</span></p><p style="margin-top:4pt; margin-right:30.3pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Vos effets/bagages non-accompagnés contiennent-ils des articles dans les catégories énoncées ci-dessous?</span><br><span style="font-family:'Times New Roman', serif; font-weight:bold">Valeurs monétaires australiennes ou étrangères (billets de banque) d’un montant supérieur à 10 000 dollars australiens?</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:11.5pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:21.1pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:12.7pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:477.8pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td style="width:11.5pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.1pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:12.7pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:477.8pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:540.5pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:12pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si vous répondez oui, veuillez fournir le montant en dollars australiens</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:540.5pt; border-top:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-top:4pt; margin-bottom:4pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Produits pharmaceutiques </span><span style="font-family:'Times New Roman', serif; font-style:italic">(prescrits ou non prescrits par un médecin) et y compris, mais sans restriction, remèdes à base d’herbes</span></p></td></tr><tr style="height:1pt"><td style="width:11.5pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:21.1pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:12.7pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:477.8pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td style="width:11.5pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.1pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:12.7pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:477.8pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:540.5pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:10pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si vous répondez oui, veuillez fournir une liste de ces produits</span></p></td></tr><tr style="height:1pt"><td style="width:11.5pt; border-top:1pt solid #000000; border-bottom:2.25pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.1pt; border-top:1pt solid #000000; border-bottom:2.25pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:12.7pt; border-top:1pt solid #000000; border-bottom:2.25pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:477.8pt; border-top:1pt solid #000000; border-bottom:2.25pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Section Cinq</span></p><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Vos effets/bagages non-accompagnés contiennent-ils des marchandises appartenant aux catégories énoncées ci-dessous?</span></p><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Si votre réponse est OUI veuillez décrire la nature de ces marchandises dans le tableau ci-dessous.</span></p><p style="margin-top:6pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-style:italic">Cigarettes, cigares ou tabac</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:9.55pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:24.7pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:11.5pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:463.65pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:526.8pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-top:6pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-style:italic">Alcool y compris eaux de vie, spiritueux, vins et bières.</span></p></td></tr><tr style="height:1pt"><td style="width:9.55pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:24.7pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:11.5pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:463.65pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:526.8pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-top:6pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-style:italic">Véhicule à moteur, motocyclette, remorque ou véhicule marin.</span></p></td></tr><tr style="height:1pt"><td style="width:9.55pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:24.7pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:11.5pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:463.65pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:526.8pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-top:6pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-style:italic">Effets appartenant à une personne étrangère autre que vous ou les personnes qui vous ont accompagné en Australie.</span></p></td></tr><tr style="height:1pt"><td style="width:9.55pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:24.7pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:11.5pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:463.65pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:526.8pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-style:italic">Marchandises destinées à une activité commerciale, à la vente, à la location ou à l’échange commercial.</span></p></td></tr><tr style="height:1pt"><td style="width:9.55pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:24.7pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:11.5pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:463.65pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:526.8pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-style:italic">Autres marchandises en votre possession depuis moins de 12 mois.</span></p></td></tr><tr style="height:1pt"><td style="width:9.55pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:24.7pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:11.5pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:463.65pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr></tbody></table><p style="margin-top:8pt; margin-bottom:7pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Si cet espace est insuffisant veuillez fournir une liste en annexe</span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:304.3pt; border-right:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:0pt; text-align:center; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Description</span></p></td><td style="width:136.05pt; border-right:1pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Valeur à l'achat ou estimée en dollars australiens</span></p></td><td style="width:90.2pt; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:0pt; text-align:center; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Date d'achat</span></p></td></tr><tr style="height:1pt"><td style="width:304.3pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:13pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:136.05pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:90.2pt; border-top:0.75pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:304.3pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:13pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:136.05pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:90.2pt; border-top:0.75pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:304.3pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:13pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:136.05pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:90.2pt; border-top:0.75pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:304.3pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:13pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:136.05pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:90.2pt; border-top:0.75pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:304.3pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:13pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:136.05pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:90.2pt; border-top:0.75pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:304.3pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:13pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:136.05pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:90.2pt; border-top:0.75pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:304.3pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:13pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:136.05pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:90.2pt; border-top:0.75pt solid #000000; border-left:1pt solid #000000; border-bottom:0.75pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:304.3pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:13pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:136.05pt; border-top:0.75pt solid #000000; border-right:1pt solid #000000; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:90.2pt; border-top:0.75pt solid #000000; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">NOTE IMPORTANTE : </span><span style="font-family:'Times New Roman', serif; font-weight:bold; font-style:italic">Toute marchandise en votre possession depuis moins de 12 mois doit être déclarée. Ces marchandises seront évaluées en vue de déterminer le montant des taxes et droits de douane. Vous vous exposez au risque d’être pénalisé si ces marchandises ne sont pas déclarées. Renseignez-vous auprès du service d’information des douanes accessible par téléphone au 1300 363 263.</span></p><p style="margin-bottom:10pt; line-height:normal; border-bottom:2.25pt solid #000000; padding-bottom:1pt; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p><p style="margin-bottom:2pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Section Six</span></p><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Dans le mois ayant précédé l'envoi de ces effets, bagages ou articles en Australie, avez-vous, ou tout autre membre de votre famille, étant arrivé ou devant arriver avec vous en Australie, visité une ferme avec des animaux, une coopérative fermière ou un lieu de recherche scientifique sur les animaux, une réserve d'animaux ou un lieu de vente de bétail, un abattoir ou lieu d'exploitation de viande animale?</span></p><table cellspacing="0" cellpadding="0" style="width:532.8pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:9.95pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:24.35pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:11.75pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:463.55pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"></p></td></tr></tbody></table>

<table cellspacing="0" cellpadding="0" style="width:544.3pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr><td style="width:534.7pt; padding:2.15pt 3.8pt; vertical-align:top; background-color:#d9dadb"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Je soussigné déclare que les renseignements fournis dans ce formulaire sont, dans les limites de mon savoir, véridiques</span><span style="font-family:'Times New Roman', serif; font-weight:bold"> </span><span style="font-family:'Times New Roman', serif; font-weight:bold">et</span><span style="font-family:'Times New Roman', serif; font-weight:bold"> </span><span style="font-family:'Times New Roman', serif; font-weight:bold">corrects; avoir compris le sens des questions posées dans ce formulaire et y avoir répondu de façon véridique et</span><span style="font-family:'Times New Roman', serif; font-weight:bold"> </span><span style="font-family:'Times New Roman', serif; font-weight:bold">correcte.</span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:444.2pt; border-right:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Signature du propriétaire</span></p></td><td style="width:94.5pt; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Date</span></p></td></tr><tr style="height:1pt"><td style="width:444.2pt; border-right:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:94.5pt; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"></p></td></tr></tbody></table>

<table cellspacing="0" cellpadding="0" style="width:544.3pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr><td style="width:534.7pt; padding:2.15pt 3.8pt; vertical-align:top; background-color:#d9dadb"><p style="margin-top:4pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Section Sept</span></p><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Vos effets/bagages non-accompagnés contiennent-ils des articles appartenant à l’une des catégories d’articles sujets à des restrictions légales concernant la quarantaine animale, l’exportation d’animaux sauvages ou les importations telles qu’enoncées ci-dessous?</span></p><p style="margin-top:2pt; margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Animaux </span><span style="font-family:'Times New Roman', serif">vivants ou morts y compris tous mamifères, reptiles, poissons, oiseaux ou partie de ces animaux et </span><span style="font-family:'Times New Roman', serif; font-weight:bold">produits derivés d’animaux </span><span style="font-family:'Times New Roman', serif">y compris; </span><span style="font-family:'Times New Roman', serif; font-style:italic">plumes, peaux, cornes, coquilles, oeufs prêts à éclore, semen et embryons.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:8.35pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:3pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:26.85pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:3pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:9.3pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:3pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:476.6pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:3pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:538.5pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:12pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si votre réponse est oui, veuillez fournir une liste de ces articles</span></p></td></tr></tbody></table><p style="margin-top:3pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Nourriture de toute nature </span><span style="font-family:'Times New Roman', serif">(y compris pour la consommation immédiate) comme toute </span><span style="font-family:'Times New Roman', serif; font-style:italic">viande de bétail ou de volaille, oeufs, produits laitiers, produit d’alimentation pour bébés, produits à tartiner ou sauces, boissons alcoolisées ou non-alcoolisées.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:11.25pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:26.35pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:10.05pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:475.9pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td style="width:11.25pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:26.35pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.05pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:475.9pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:3pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:540.95pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:12pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si votre réponse est oui, veuillez fournir une liste de ces articles</span></p></td></tr></tbody></table><p style="margin-top:3pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Equipement </span><span style="font-family:'Times New Roman', serif">utilisé pour l’exploitation des chevaux et autres animaux y compris; </span><span style="font-family:'Times New Roman', serif; font-style:italic">selle d’équitation ou autre, harnais, fouet, collier, brosse, couverture ou toute autres tapis ou matelas utilisés en tant que literie.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:11.95pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:4pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:21.55pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:4pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:13.65pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:4pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:474.45pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:4pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:539pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:12pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si votre réponse est oui, veuillez fournir une liste de ces articles</span></p></td></tr></tbody></table><p style="margin-top:3pt; margin-bottom:2pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Spécimens biologiques </span><span style="font-family:'Times New Roman', serif">y compris:</span></p><p style="line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-style:italic">vaccins, cultures, échantillons sanguins, échantillons cellulaires ou lignées cellulaires, semen ou embryons.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:10.05pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:24.45pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:11.95pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:475.4pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:539.25pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:middle; background-color:#ffffff"><p style="margin-bottom:12pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si votre réponse est oui, veuillez fournir une liste de ces articles</span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; border-bottom:2.25pt solid #000000; padding-bottom:1pt; font-size:4pt"><span style="font-family:'Times New Roman', serif; font-weight:bold"></span></p><p style="margin-bottom:0pt; line-height:normal; font-size:12pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Section Huit</span></p><p style="margin-top:4pt; margin-bottom:7pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Vos effets/bagages non-accompagnés contiennent-ils des articles dans les catégories énoncées ci-dessous qui sont sujettes à des restrictions légales concernant la quarantaine des végétaux?</span></p><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Plantes ou parties de plantes </span><span style="font-family:'Times New Roman', serif">en vie ou morte y compris:</span></p><p style="margin-bottom:4pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-style:italic">Fruits, noix de toute sorte, bulbes, feuilles, article en bois ou fabriqué à partir de plantes végétales, échantillons et coupes de plantes, boutures, fleurs, champignons, herbes, infusions ou thés.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:12.2pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:20.85pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:14.6pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:475.4pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:540.45pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:7pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si votre réponse est oui, veuillez fournir une liste de ces articles</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:540.45pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:7pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table><p style="margin-top:4pt; margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Meubles </span><span style="font-family:'Times New Roman', serif">ou articles en bois, bambou ou rotin.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:11pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:23pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:12.7pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:476.85pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:540.95pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:14pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si votre réponse est oui, veuillez fournir une liste de ces articles</span></p></td></tr></tbody></table><p style="margin-top:5pt; margin-bottom:5pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Echantillons de terre ou de sol </span><span style="font-family:'Times New Roman', serif">contenant de la terre, du sable, des pierres ou des échantillons minéraux.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:11.7pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:21.55pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:14.1pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:476.1pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr><tr style="height:1pt"><td style="width:11.7pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:2pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.55pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:2pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.1pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:2pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:476.1pt; border-bottom:1pt solid #000000; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:2pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="4" style="width:540.85pt; border:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:12pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Si votre réponse est oui, veuillez fournir une liste de ces articles</span></p></td></tr></tbody></table><p style="margin-top:4pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Eléments d’emballage en </span><span style="font-family:'Times New Roman', serif; font-weight:bold">paille ou en bois </span><span style="font-family:'Times New Roman', serif">autres que des copeaux ou de la sciure de bois.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:12.9pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:20.85pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:13.65pt; padding:1.45pt 2.9pt; vertical-align:top"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:476.6pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr></tbody></table><p style="margin-top:4pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Articles d’emballage tels que </span><span style="font-family:'Times New Roman', serif; font-weight:bold">cartons pour fruits ou œufs.</span></p><table cellspacing="0" cellpadding="0" style="width:534.2pt; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:13.65pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:21.1pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Oui</span></p></td><td style="width:14.1pt; padding:1.45pt 2.9pt; vertical-align:bottom"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><img src="image.003.png" width="14" height="14" alt=""></p></td><td style="width:474.9pt; padding:1.45pt 2.9pt; vertical-align:middle"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Non</span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"></p></td></tr></tbody></table>

<table cellspacing="0" cellpadding="0" style="width:544.3pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr><td style="width:534.7pt; padding:2.15pt 3.8pt; vertical-align:top; background-color:#d9dadb"><p style="margin-bottom:4pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Je soussigné déclare que les renseignements fournis dans ce formulaire sont, dans les limites de mon savoir, véridiques et corrects; avoir compris le sens des questions posées dans ce formulaire et y avoir répondu de façon véridique et correcte.</span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:437.25pt; border-right:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:14pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Signature du propriétaire</span></p></td><td style="width:96.7pt; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:12.5pt; margin-bottom:14pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Date</span></p></td></tr></tbody></table><p style="margin-top:4pt; margin-bottom:6pt; line-height:normal; font-size:10pt"></p></td></tr></tbody></table>

<table cellspacing="0" cellpadding="0" style="width:544.3pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr><td style="width:534.7pt; padding:2.15pt 3.8pt; vertical-align:top; background-color:#d9dadb"><p style="margin-bottom:4pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">A USAGE OFFICIEL (OFFICIAL USE ONLY)</span></p><table cellspacing="0" cellpadding="0" style="width:535.2pt; margin-bottom:0pt; border:1pt solid #000000; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:242.85pt; border-right:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Goods declared</span></p></td><td style="width:291.3pt; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:top; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif; font-weight:bold">Action taken</span></p></td></tr><tr style="height:1pt"><td style="width:242.85pt; border-right:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-bottom:0pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:291.3pt; border-left:1pt solid #000000; padding:1.45pt 2.4pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-top:80pt; margin-bottom:6pt; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">ICD number:</span></p></td></tr></tbody></table><p style="margin-bottom:0pt; line-height:normal; font-size:1pt"></p></td></tr></tbody></table>