Form CBP Form 7551 CBP Form 7551 Drawback Entry

DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection DRAWBACK ENTRY 19 CFR 191 PAPERWORK REDUCTION ACT NOTICE: This request is in accordance with the Paperwork Reduction Act. We ask for the information in order to carry out U.S. Department of Homeland Security laws and regulations, to determine the eligibility for refund of taxes on domestic alcohol (if applicable), and to determine the proper amount of drawback. Your response is required to obtain or retain a benefit. The estimated average burden associated with this collection of information is 35 minutes per respondent depending on individual circumstances. Comments concerning the accuracy of this burden estimates and suggestions for reducing this burden should be directed to U.S. Customs and Border Protection, Information Services Division, Washington, DC 20229, and to the Office of Management and Budget, Paperwork Reduction Project (1651-0075) Washington, DC 20503.

Section I - Claim Header OMB 1651-0075 Expires 08/31/2008

1. Drawback Entry Number

2. Entry Type Code

3. Port Code

4. Surety Code

5. Bond Type

6. Claimant ID Number

7. Broker ID Number (CBP 4811)

8. DBK Ruling Number

9. Duty Claimed

10. Puerto Rico Claimed

11. HMF Claimed

12. MPF Claimed

13. Other Taxes/Fees Claimed

14. Total Drawback Claimed

15. Total I.R. Tax Claimed

16. Method of Filing ABI Manual Disk

17. NAFTA DBK Yes No

18. Privilege Authorized Accelerated Payment WPN

19. Drawback Statutory Provision

20. Name and Address of Claimant

21. Contact Name, Address, E-mail, Phone & Fax Numbers of Preparer

Section II - Imported Duty Paid, Designated Merchandise or Drawback Product

22. Import Entry or CM&D Numbers (List Once in Chronological Order)

23. Port Code

24. Import Date

25. CD

26. (If using 1313(b)) B. Date(s) Date(s) Received Used

27. HTSUS No.

28. Description of Merchandise (Include Part /Style/Serial Numbers)

29. Quantity & Unit of Measure

30. Entered Value Per Unit

31. Duty Rate

32. 99% Duty

33. Total

34. STATUS - The Import entries listed on this form are subject to: (Must be identified on claim or coding sheet)

CBP USE ONLY

Class Code

Accelerated

Liquidated

Bill/Refund

Reconciliation 19 USC 1520 (c)(1)

19 USC 1514, Protest 19 USC 1520 (d)

364 Duty

365 Excise Tax

369 Puerto Rico

398 HMF

DATE RECEIVED

399 MPF

______Other Tax or Fee

Total Drawback Claimed

INTERNAL CONTROL REVIEW Date _____________________ DS Number __________________ IC OK

Reason 21 23 24 25 26

Specialist Code

CBP Form 7551 (07/08)

Section III - Manufactured Articles
35. Quantity & Description of Merchandise Used			36. Date(s) of Manufacture or Production	37. Description of Articles Manufactured or Produced	38. Quantity and Unit of Measure		39. Factory Location
Section IV - Information on Exported or Destroyed Merchandise
PERIOD COVERED ___________________ TO ____________________
40. Exhibits to be attached for the following: Relative Value Petroleum Domestic Tax Paid Alcohol Piece Goods Waste Calculation Recycled						Harbor Maintenance Fee Merchandise Processing Fee Other Taxes/Fees
41. Date (MMDDYYYY)	42. Action Code	43. Unique Identifier No.	44. Name of Exporter/Destroyer	45. Description of Articles (Include Part /Style/Serial Numbers)	46. Quantity and Unit of Measure		47. Export Destination	48. HTSUS No.
Section V - Declarations
The undersigned acknowledges statutory requirements that all records supporting the information on this document are to be retained by the issuing party for a period of three years from the date of payment of the drawback claim. The undersigned is fully aware of the sanctions provided in 18 U.S.C. 1001 and 18 U.S.C. 550 and 19 U.S.C. 1593a. I declare that according to the best of my knowledge and belief, all of the statements in this document are correct and that the exported article is not to be relanded In the United States or any of its possessions without paying duty. Printed Name and Title Signature and Date Same condition to NAFTA countries - The undersigned herein certifies that the merchandise herein described is in the same condition as when it was imported under above import entry(ies) and further certifies that this merchandise was not subjected to any process of manufacturer or other operation except the following allowable operations: ______________________________________ The undersigned hereby certifies that the merchandise herein described is unused in the United States and further certifies that this merchandise was not subjected to any process of manufacture or other operation except the following allowable operations:_______________________________________________________________________________________________________________ The undersigned hereby certifies that the merchandise herein described is commercially interchangeable with the designated imported merchandise and further certifies that the substituted merchandise is unused in the United States and that the substituted merchandise was in our possession prior to exportation or destruction. Merchandise does not conform to sample or specifications. Merchandise was defective at time of importation. Merchandise was shipped without consent of the consignee. The undersigned hereby certifies that the merchandise herein described is the same kind and quality as defined in 19 U.S.C. 1313(p)(3)(B), with the designated imported merchandise or the article manufactured or produced under 1313(a) or (b), as appropriate. The article(s) described above were manufactured or produced and exported or destroyed as stated herein in accordance with the drawback ruling on file with CBP and in compliance with applicable laws and regulations. Member of Firm with Power of Attorney Officer of Corporation Broker with Power of Attorney

CBP Form 7551 (07/08)