Dominican Republic E-Ticket Official Application

General Information

Country of Residence *

City *

Permanent Home Address *

State / Province / Region

Email Address *

Confirm Email Address *

Passenger Information

First Name *Enter your First Name as shown on your passport.

Family Name *Enter your Family Name as shown on your passport.

Gender *MaleFemale

Date of birth *

Country of birth *

Country of passport *

Passport Number *Enter the Passport Number exactly as shown on the biographic information page. Pay close attention to the letters O and 0; and I and 1.

Сivil Status *

Profession / Activity *

Travel Information

Name of the departure airport *

Name of the arrival airport *

Airline Name *

Flight Number *

Flight Date *

Hotel name or address at the Dominican Republic *Please indicate the Address of your Accommodation, Host, or the Hotel Name

Travel Purpose *

Length of Stay (in days) *

Do you bring with you or in your luggage monetary values greater than 10,000.00 USD or its equivalent in another type of currency? *YesNo

Do you bring live animals, plants or food products with you or in your luggage? *YesNo

Do you bring taxable goods with you or in your luggage? *YesNo*Note: The presentation of this declaration is mandatory for all passengers leaving or entering the Dominican Republic. For minors, this form must be completed and signed by the responsible adult. The declaration of erroneous or incomplete information may lead to sanctions such as the seizure of titles, goods and deprivation of liberty, in accordance with article 200 of law 3489, of the customs regime, and article 4 of the law N °. 155-17 against money laundering. This declaration must be signed by the passenger when indicated.

General Information

Passenger Information

Travel Information

Declaration of Applicant