Video film declaration

 

 

 

I, ______________________ certify that the film / video imported by

 

(consignee)_______________________________________________

 

from (country) ____________________ by Federal Express on (date)

 

______ 20 ____ , under air way bill number ____________________

 

contains no obscene or immoral matter, nor any matter advocating or

 

urging treason or  insurrection against  the United States of America,

 

nor any threat to take the life or inflict bodily harm upon any person

 

in the United States.

 

 

 

 

 

____________________

(Signature)