US customs declaration form for international travelers

Taken from U.S. Customs and Border Protection site 
U.S. Customs and Border Protection Declaration Form – Front
1. Print your last (family) name. Print your first (given) name. Print the first letter of your middle name.
 
2. Print your date of birth in the appropriate day/month/year boxes.
 
3. Print the number of family members traveling with you (do not include [...]