Mexico Travel Declaration Form

Full Name

First NameLast Name

Date of Birth

Date

Nationality

Email Address

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Country of Residence

Passport Issuing Country

The Last 4 Digits of Your Passport

Arrival Date in Mexico

Date

Flight Number or Border Entry Point

Purpose of Visit

Address in Mexico (Hotel or Residence)

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Emergency Contact Name and Phone Number

Are you bringing any of the following into Mexico? (Select all that apply)

Have you visited any countries in the last 14 days? If yes, please list them.