Declaration For Free Entry Of Unaccompanied Articles (Page 2 of 4) in pdf

Declaration For Free Entry Of Unaccompanied Articles Page 2

D. LIST OF ARTICLES

(1) ITEM NUMBER CHECKED

(2) DESCRIPTION OF MERCHANDISE

(3) VALUE OR

(4) FOREIGN MERCHANDISE TAKEN ABROAD

IN PART IV, A., B., C.

COST OF

THIS TRIP: S ta te w h e re in th e U .S . th e fo re ig n

REPAIRS

m e rc h a n d is e w a s a c q u ire d o r w h e n a n d w h e re it

w a s p re v io u s ly d e c la re d to U .S . C u s to m s .

PART V— CARRIER'S CERTIFICATE AND RELEASE ORDER

The undersigned carrier, to whom or upon whose order the articles described in PART I, 8., must be released, hereby certifies that the person named in Part I, 1., is the owner or consignee of

such articles within the purview of section 484(h), Tariff Act of 1930.

In accordance with the provisions of section 484(h), Tariff Act of 1930, authority is hereby given to release the articles to such consignee.

1. NAME OF CARRIER

2. SIGNATURE OF AGENT (Print and sign)

Date

PART VI— CERTIFICATION TO BE COMPLETED BY ALL PERSONS SEEKING FREE ENTRY

I, the undersigned, certify that this declaration is correct and complete.

1. "X" One

A. Authorized Agent* (From facts obtained from the importer)

B. Importer

2. SIGNATURE

3. DATE

*A n A u th o riz e d A g e n t is d e fin e d a s a p e rs o n w h o h a s a c tu a l k n o w le d g e o f th e fa c ts a n d w h o is s p e c ific a lly e m p o w e re d u n d e r a p o w e r o f a tto rn e y to e x e c u te th is d e c la ra tio n (s e e 1 9 C F R 1 4 1 .1 9 , 1 4 1 .3 2 , 1 4 1 .3 3 ).

1. SIGNATURE OF CUSTOMS OFFICIAL

2. DATE

PART VII— CUSTOMS USE ONLY

(Inspected and Released)

Customs Form 3299 (100695)(Back)