Entry/immediate Delivery printable pdf download

U.S. DEPARTMENT OF HOMELAND SECURITY

Form Approved

Bureau of Customs and Border Protection

OMB No. 1651-0024

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/ AWB

22. IT/BL/AWB NO.

23. MANIFEST QUANTITY

24. H.S. NUMBER

25. COUNTRY

26. MANUFACTURER NO.

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 sufficient, valid, and current, and that all

requirements of 19 CFR Part 142 have been met.

SIGNATURE OF APPLICANT

PHONE NO.

DATE

CBP EXAMINATION REQUIRED.

29. BROKER OR OTHER GOVT. AGENCY USE

ENTRY REJECTED, BECAUSE:

SIGNATURE

DATE

DELIVERY

AUTHORIZED:

PAPERWORK REDUCTION ACT NOTICE: This information is 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 depending on individual circumstances. Comments concerning the accuracy

of this burden estimate and suggestions for reducing this burden should be directed to Bureau of Customs and Border Protection, Information Services Branch,

Washington, DC 20229, and to the Office of Management and Budget, Paperwork Reduction Project (1651-0024), Washington, DC 20503.

CBP Form 3461 (01/89)