Bureau Of Customs And Border Protection Entry / Immediate Delivery

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TABS:
U.S. DEPARTMENT OF HOMELAND SECURITY
OMB No. 1651-0024
Bureau of Customs and Border Protection
ENTRY / IMMEDIATE DELIVERY
19 CFR 142.3, 142.16, 142.22, 142.24
1. ARRIVAL DATE
2. ELECTED ENTRY DATE
3. ENTRY TYPE CODE / NAME
4. ENTRY NUMBER
5. PORT
6. SINGLE TRANS. BOND
7. BROKER / IMPORTER FILE NUMBER
8. CONSIGNEE NUMBER
9. IMPORTER NUMBER
10. ULTIMATE CONSIGNEE NAME
11. IMPORTER OF RECORD NAME
12 CARRIER CODE
13. VOYAGE / FLIGHT / TRIP
14. LOCATION OF GOODS — CODE(S) / NAME(S)
15. VESSEL CODE / NAME
16. U.S. PORT OF UNLADING
17. MANIFEST NUMBER
18. G.O. NUMBER
19. TOTAL VALUE
20. DESCRIPTION OF MERCHANDISE
21. IT / BL /
22. IT / BL / AWB NO.
23. MANIFEST QUANTITY
24 H.S. NUMBER
25. COUNTRY
26. MANUFACTURER NO.
AWB CODE
OF ORIGIN
27. CERTIFICATION
28. CBP USE ONLY
I hereby make application for entry / immediate delivery. I certify that the above
OTHER AGENCY ACTION REQUIRED, NAMELY:
information is accurate, the bond is suffi cient, valid, and current, and that all
requirements of 19 CFR Part 142 have been met.
SIGNATURE OF APPLICANT
X
PHONE NO.
DATE
CUSTOMS EXAMINATION REQUIRED.
29. BROKER OR OTHER GOVT. AGENCY USE
ENTRY REJECTED, BECAUSE:
SIGNATURE
DATE
DELIVERY
AUTHORIZED:
PAPERWORK REDUCTION ACT NOTICE: This information is needed to determine the admissibility of imports into the United States and to provide the necessary
information for the examination of the cargo and to establish the liability for payment of duties and taxes. Your response is necessary. The estimated average burden
associated with this collection of information is 15 minutes per respondent or recordkeeper depending on individual circumstances. Comments concerning the
accuracy of this burden estimate and suggestions for reducing this burden should be directed to the Bureau of Customs and Border Protection, Information Services
Branch, Washington, DC 20229, or the Paperwork Reduction Project (1651-0024), Office of Management and Budget, Washington, DC 20503.
CBP Form 3461 (01/89)

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