Continuous Bond Application - Itg Boston
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1Continuous Bond Application
CHB Name:
Importer Name:
Importer Number:
DBA:
Corporation
(State of Incorporation:
)
/ Partnership
/ Proprietorship
/ Individual
If Partnership, indicate if General
or Limited
If Proprietorship, indicate name of Sole Proprietor:
Co-Principals / Users: Yes
No
(If yes, add sheet with Name, Importer Number, Address)
Physical Address:
City/State/Zip Code:
Mailing Address:
City/State/Zip Code:
Phone:
Years in Business:
Activity Code:
1
1A
2
3
3A
4
5
16
Bond Amount Requested:
Effective Date Requested:
(Note: CBP requires at least 15 days to file a bond.)
For Activity Code 1 – Import Bonds Only – CBP 301 form, please fill out below:
Description of merchandise
to be imported:
Country(ies) of Origin:
Is merchandise subject to antidumping/countervailing
Yes
No
duties?
Is a current bond on file (same activity code)?
Yes
No
Has termination been sent on current bond?
Yes
No
If yes, termination date:
Is the Importer on Periodic Monthly Statement?
Yes
No
Does the Importer require a Reconciliation Rider?
Yes
No
Has any Surety ever suffered a loss on Principal’s
Yes
No
behalf?
Previous Calendar Year
Estimated For Next Calendar Year
Value of Merchandise:
Estimated Duties:
Number of Entries:
Certification
I certify that the factual information contained in this application is true and accurate and any information provided which is
based upon estimates is based upon the best information available on the date of this application.
Signature of officer or attorney-in-fact
Date
Printed name and title
Roanoke Trade Services, Inc. Rev. 01/10
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