Form ITA-361P Request for Refund of Duties on Articles Entered Duty Pa

OMB No. 0625-0134
Expires xx/xx/xxxx

U. S. DEPARTMENT OF COMMERCE

U. S. DEPARTMENT OF THE INTERIOR

REQUEST FOR REFUND OF DUTIES
ON ARTICLES ENTERED DUTY PAID
(P.L. 97-446, AS AMENDED BY P.L. 103-465, P.L. 106-36 AND P.L. 108-429)

FORM ITA-361P
REV. 3-06

This form must be completed in order to obtain duty refunds pursuant to P.L. 97-446, AS AMENDED BY P.L. 103-465, P.L. 106-36 AND P.L. 108-429

A. This request for refund is made pursuant to Certicate of Entitlement (Form ITA-360P) Number
issued to
, on
, and expiring
B. The number of this request is

and is in the amount of $

C. Duties are requested to be refunded to:

,
.

.
.

,

Name

Address

.
City, State, ZIP Code

Check whether affiliated

Signature of Authorized Company Official

or not affiliated

D. Certification by Department of Commerce:

with the certificate holder.
,

Date

FTS Number

,
Typed name and title

Signature

INSTRUCTIONS FOR CERTIFICATE HOLDER:
Complete blocks A, B, and C. Enter the related information requested on the reverse side of your
certificate (Form ITA-360P), sign in block C above, and submit to:
Subsidies Enforcement Office
Enforcement & Compliance
U.S. Department of Commerce
Room 3713
1401 Constitution Ave, NW
Washington, D.C. 20230

Public reporting for this collection of information is established to average 10 minutes per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the date needed,
and completing and reviewing the collection of information. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden to Reports
Clearance Officer, Internatinal Trade Administration, U.S. Dept. of Commerce, Room 4001, 14th &
Constitution Ave. NW, Washington, D.C. 20230.

Your copy (Copy E) will be returned to you after certification by the Department of Commerce.

INSTRUCTIONS FOR CUSTOMS OFFICIAL:
Provided that this form is presented to you on or before the expiration date shown in block A and the certifications in
block D above and block E (1) of Copy B have been executed, you are authorized to refund duties on articles that
entered the United States duty paid with the exception of articles containing any material which is the product of a
country with respect to which Column 2 rates of duty apply, which were made within the three-year period beginning
two years prior to the date of issuance of the Certificate of Entitlement described in block A. This request for refund
of duties must be presented to you by the party shown in block C, together with any other documentation required by
applicable regulations of the U.S. Customs and Border Protection. You may verify the validity of this request by
telephoning the Commerce official shown in block D. You may verify the information supplied by the claimant in
block E (1) from your records. After the U.S. Customs and Border Protection has refunded the requested duties,
enter the pertinent information in block E (2) of Copy B, ensuring that the information is legible on the remaining
copies. This form may be used as often as necessary to exhaust the amount shown in block B. When the total amount
of gross duties refunded equals the amount shown in block B, return the original and Copy C to Commerce at the
address shown above. The form should also be returned to Commerce in the event it is presented after the expiration
date shown in block A, and in that event no refund of duties is permitted. If additional instructions are needed,
telephone the Commerce official shown in block D. THE ORIGINAL AND COPIES B, C, AND D SHOULD
REMAIN AFFIXED TOGETHER UNTIL EXPIRATION OR THE AMOUNT IN BLOCK B IS EXHAUSTED,
WHICHEVER OCCURS FIRST.

ORIGINAL

THIS DOCUMENT MUST BE PRESENTED TO THE U.S. CUSTOMS AND BORDER PROTECTION OFFICER AT THE PORT OF
ENTRY WHERE THE ARTICLES FOR WHICH REFUND OF DUTIES IS REQUESTED WERE ENTERED PORT OF ENTRY
WHERE THE ARTICLES FOR WHICH REFUND OF DUTIES IS REQUESTED WERE ENTERED

OMB No. 0625-0134
Expires 04/30/2012

U. S. DEPARTMENT OF COMMERCE
FORM ITA-361P
REV. 3-06

U. S. DEPARTMENT OF THE INTERIOR

REQUEST FOR REFUND OF DUTIES
ON ARTICLES ENTERED DUTY PAID
(P.L. 97-446, AS AMENDED BY P.L. 103-465, P.L. 106-36 AND P.L. 108-429)

A. This request for refund is made pursuant to Certificate of Entitlement (Form ITA-360P) Number
issued to
, on
, and expiring
B. The number of this request is

and is in the amount of $

,
.

.

C. Duties are requested to be refunded to:

.

,

Name

Address

.
City, State, ZIP Code

Signature of Authorized Company Official

Check whether affiliated

or not affiliated

D. Certification by Department of Commerce:

with the certificate holder.
,

Date

FTS Number

,
Typed name and title

Signature

E. Refund Information:
(1) Refunds requested: (to be completed by claimant)
FY

Entry number

Port

Entry date

Duties

Claimant’s
initials/date
(each claim)

(2) Refunds paid: (to be completed by Customs)
Gross duties refunded:
Less Customs reimbursement:
Net duties refunded:
/
Customs initials date

Subtotal:
Gross duties refunded:

Less Customs reimbursement:
Net duties refunded:
Subtotal:

/
Customs initials date

Gross duties refunded:

Less Customs reimbursement:
Net duties refunded:
Subtotal:

/
Customs initials date

Gross duties refunded:

Less Customs reimbursement:
Net duties refunded:
Subtotal:

/
Customs initials date

Gross duties refunded:

Less Customs reimbursement:
DECLARATION BY CLAIMANT: I declare that the information given above is true
and correct to the best of my knowledge and belief; that no notices of exportation of
articles with benefit of drawback were filed upon exportation of this merchandise
from the United States; that no liquidated refunds on the articles relating to the
present claim have been paid; and that no protest or request for litigation for refund of
duties paid and herewith claimed has been made.

Net duties refunded:
/

Customs initials date

Subtotal:
TOTAL:

Customs signature (when last refund is made)

COPY B
NOTICE TO CUSTOMS: Do not accept this document unless it is accompanied by the original (see instructions thereon). After
completing block E (2), retain this copy for your records. Copy C is the Department of Commerce copy. Copy D is the broker's copy.

OMB No. 0625-0134
Expires 04/30/2012

U. S. DEPARTMENT OF COMMERCE
FORM ITA-361P
REV. 3-06

U. S. DEPARTMENT OF THE INTERIOR

REQUEST FOR REFUND OF DUTIES
ON ARTICLES ENTERED DUTY PAID
(P.L. 97-446, AS AMENDED BY P.L. 103-465, P.L. 106-36 AND P.L. 108-429)

A. This request for refund is made pursuant to Certificate of Entitlement (Form ITA-360P) Number
issued to
, on
, and expiring
B. The number of this request is

and is in the amount of $

,
.

.

C. Duties are requested to be refunded to:

.

,

Name

Address

.
City, State, ZIP Code

Signature of Authorized Company Official

Check whether affiliated

or not affiliated

D. Certification by Department of Commerce:

with the certificate holder.
,

Date

FTS Number

,
Typed name and title

Signature

E. Refund Information:
(1) Refunds requested: (to be completed by claimant)
FY

Entry number

Port

Entry date

Duties

Claimant’s
initials/date
(each claim)

(2) Refunds paid: (to be completed by Customs)
Gross duties refunded:
Less Customs reimbursement:
Net duties refunded:
/
Customs initials date

Subtotal:
Gross duties refunded:

Less Customs reimbursement:
Net duties refunded:
Subtotal:

/
Customs initials date

Gross duties refunded:

Less Customs reimbursement:
Net duties refunded:
Subtotal:

/
Customs initials date

Gross duties refunded:

Less Customs reimbursement:
Net duties refunded:
Subtotal:

/
Customs initials date

Gross duties refunded:

Less Customs reimbursement:
DECLARATION BY CLAIMANT: I declare that the information given above is true
and correct to the best of my knowledge and belief; that no notices of exportation of
articles with benefit of drawback were filed upon exportation of this
merchandise from the United States; that no liquidated refunds on the articles
relating to the present claim have been paid; and that no protest or request for
litigation for refund of duties paid and herewith claimed has been made.

Claimant’s signature (when first claim is made)

Net duties refunded:
/

Customs initials date

Customs signature (when last refund is made)

COPY C

DEPARTMENT OF COMMERCE COPY

Subtotal:
TOTAL:

OMB No. 0625-0134
Expires 04/30/2012

U. S. DEPARTMENT OF COMMERCE
FORM ITA-361P
REV. 3-06

U. S. DEPARTMENT OF THE INTERIOR

REQUEST FOR REFUND OF DUTIES
ON ARTICLES ENTERED DUTY PAID
(P.L. 97-446, AS AMENDED BY P.L. 103-465, P.L. 106-36 AND P.L. 108-429)

A. This request for refund is made pursuant to Certificate of Entitlement (Form ITA-360P) Number
issued to
, on
, and expiring
B. The number of this request is

and is in the amount of $

,
.

.

C. Duties are requested to be refunded to:

.

,

Name

Address

.
City, State, ZIP Code

Signature of Authorized Company Official

Check whether affiliated

or not affiliated

D. Certification by Department of Commerce:

with the certificate holder.
,

Date

FTS Number

,
Typed name and title

Signature

E. Refund Information:
(1) Refunds requested: (to be completed by claimant)
FY

Entry number

Port

Entry date

Duties

Claimant’s
initials/date
(each claim)

(2) Refunds paid: (to be completed by Customs)
Gross duties refunded:
Less Customs reimbursement:
Net duties refunded:
/
Customs initials date

Subtotal:
Gross duties refunded:

Less Customs reimbursement:
Net duties refunded:
Subtotal:

/
Customs initials date

Gross duties refunded:

Less Customs reimbursement:
Net duties refunded:
Subtotal:

/
Customs initials date

Gross duties refunded:

Less Customs reimbursement:
Net duties refunded:
Subtotal:

/
Customs initials date

DECLARATION BY CLAIMANT: I declare that the information given above is true
and correct to the best of my knowledge and belief; that no notices of exportation of
articles with benefit of drawback were filed upon exportation of this merchandise
from the United States; that no liquidated refunds on the articles relating to the
present claim have been paid; and that no protest or request for litigation for refund of
duties paid and herewith claimed has been made.

Claimant’s signature (when first claim is made)

Gross duties refunded:

Less Customs reimbursement:
Net duties refunded:
/

Customs initials date

Customs signature (when last refund is made)

COPY D

BROKER’S COPY

Subtotal:
TOTAL:

OMB No. 0625-0134
Expires 04/30/2012

U. S. DEPARTMENT OF COMMERCE
FORM ITA-361P
REV. 3-06

U. S. DEPARTMENT OF THE INTERIOR

REQUEST FOR REFUND OF DUTIES
ON ARTICLES ENTERED DUTY PAID
(P.L. 97-446, AS AMENDED BY P.L. 103-465, P.L. 106-36 AND P.L. 108-429)

A. This request for refund is made pursuant to Certificate of Entitlement (Form ITA-360P) Number
issued to
, on
, and expiring
B. The number of this request is

and is in the amount of $

C. Duties are requested to be refunded to:

.
.

,

Name

Address

.
City, State, ZIP Code

Signature of Authorized Company Official

Check whether affiliated

or not affiliated

D. Certification by Department of Commerce:

with the certificate holder.
,

Date

FTS Number

,
Typed name and title

,
.

Signature

COPY E
NOTICE TO CERTIFICATE HOLDER: Do not remove this copy. The Department of
Commerce will return it for your records after your request is certified.