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)