Customs Form 3299 - Declaration For Free Entry Of Unaccompanied Articles, Supplemental Declaration For Unaccompanied Personal And Household Effects Etc. Page 3
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4U.S. Customs Service
New York Region
New York, NY 10048
SUPPLEMENTAL DECLARATION FOR
UNACCOMPANIED PERSONAL AND HOUSEHOLD EFFECTS
1. Owner of household goods
Last Name
First Name
Middle Name
2. Date of birth
3. Citizenship
4. Passport
Country of issue:
Number:
5. Social Security Number
6.Resident Alien Number (Green Card)
7. US Address
8. Foreign Address
Street
Street
City
State
Zip
City
State
Zip
9. Reason for moving
10. Employer
11. Position with company
12. Length of employment
13. Nature of business
14. Name and telephone number of company official who can verify above information
Name
Telephone Number
15. Name and address of freight forwarders, packers and shipping agents
Freight Forwarder Name
Telephone Number
Packer Name
Telephone Number
Shipping Agent Name
Telephone Number
16. Shipment itinerary
Place of Loading
Intermediate Ports
17. Certification (Check one)
A. Authorized Agent
B. Importer
18. Signature
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