Affidavit for Travel to Cuba I hereby understand and confirm ...

Affidavit for Travel to Cuba

I hereby understand and confirm that, under the current restrictions on travel to Cuba imposed by the United States, certain travel transactions, including, but not limited to, visits solely for the purpose of recreational tourism by citizens or residents of the United States, wheresoever located, or by any person actually within the United States, are prohibited, with the exception of the categories of travel described below.

I hereby declare that

A. I have a specific license that has been granted by OFAC before my trip. The number of my OFAC license is: __________________ (copy attached)

B. I am neither a citizen nor a resident of the United States.

or, if the above categories are not applicable, then I declare that I am traveling to Cuba for the purpose marked below:

1(a). To visit a close relative.

1(b). I share a common dwelling with an authorized traveler who has a license to visit a close relative in Cuba and am travelling with such authorized traveler to Cuba.

2.

On official business for the United States government, a foreign government or a relevant

intergovernmental organization.

3.

For journalistic purposes.

4(a). To conduct professional research related to my profession or education.

4(b). To attend a professional meeting or conference, the purpose of which is not related to the promotion of tourism in Cuba.

5(a). To participate in educational activities.

5(b). To participate in educational exchange activities not related to the pursuit of an academic degree.

6.

To engage in religious activities.

7(a). To participate in an athletic competition.

7(b). To participate in a public performance, clinic or workshop.

8.

To provide various types of support to the Cuban people.

9. people.

For a humanitarian project in or related to Cuba that is designed to directly benefit the Cuban

10. To collect information related to Cuba for noncommercial purposes.

11. For reasons regarding the exportation, importation or transmission of information or informational materials.

12. To conduct market research, commercial marketing, sales negotiation, accompanied delivery or servicing of items in Cuba.

Name: _____________________________

Date of Birth: ________________________

Telephone Number: ___________________

Address: ____________________________

Passport Country of Issue: ______________

Passport Number: _____________________

Country of Citizenship: ________________

U.S. Permanent Resident card USCIS no. or U.S. Visa Control Number: _________________________

I hereby certify that all of the information contained in this Affidavit is true and correct as of the date hereof.

Signature: __________________________

Date: _______________________________

Americas 90398798

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