Form 3347A Declaration of Congsignee When Entry is Made by an Agent

DEPARTMENT OF HOMELAND SECURITY

OMB No. 1651-0093
Exp. 07-31-2016

U.S. Customs and Border Protection

DECLARATION OF CONSIGNEE
WHEN ENTRY IS MADE BY AN AGENT
19 CFR 141.19(B)(2)

If this declaration is made by an agent who does not present with the entry the declaration of the consignee, or who does not have proper authority to
execute such declaration for this principal, bond must be given to produce such declaration in accordance with Section 485(c), Tariff Act of 1930.
THIS DECLARATION MUST BE PRESENTED TO THE PORT DIRECTOR OF CBP AT THE PORT OF ENTRY WITHIN SIX MONTHS AFTER THE DATE
OF THE BOND GIVEN THEREFORE, UNLESS AN EXTENSION OF TIME IS GRANTED BY THE PORT DIRECTOR.
1. NAME OF CONSIGNEE

2. ADDRESS (STREET, CITY, STATE, ZIP CODE)

3. VESSEL/CARRIER ARRIVED FROM
7.
NUMBER
OF
PACKAGES

4. NAME OF VESSEL/CARRIER

8.
SELLER OR SHIPPER

9.
PLACE AND DATE
OF INVOICE

10.
AMOUNT PAID
OR TO BE PAID IN
FOREIGN
CURRENCY

5. ENTRY NUMBER

11.
RATE OF
EXCHANGE

12.
ENTERED VALUE
(FOREIGN
CURRENCY)

6. DATE
13.
ENTERED
VALUE (U.S.
DOLLARS)

COMPLETE SECTION I, OR SECTION II, OR SECTION III (CHECK ONE) AND SECTION IV.
SECTION I

DECLARATION OF NOMINAL CONSIGNEE

14. NAME OF OWNER

15. ADDRESS (STREET, CITY, STATE, ZIP CODE)

I, the undersigned, herewith declare that the consignee in whose name the entry covering the merchandise described herein was made, is not the actual
owner of the said merchandise, but that such entry exhibits a full and complete account of all the merchandise imported in the vessel indicated therein by
the above name person who is the actual owner for CBP purposes of the said merchandise except as listed below.
SECTION II

DECLARATION OF CONSIGNEE FOR MERCHANDISE OBTAINED
IN PURSUANCE OF A PURCHASE OR AGREEMENT TO PURCHASE

I, the undersigned, representing the above name consignee, herewith declare that they are the consignees for CBP purposes of the merchandise described
herein, that the entry covering the said merchandise exhibits a full and complete account of all the merchandise imported by them in the vessel indicated in
the said entry and that the said merchandise was obtained by them in pursuance of a purchase or an agreement to purchase, except as listed below.
SECTION III

DECLARATION OF CONSIGNEE FOR MERCHANDISE OBTAINED OTHERWISE THAN
IN PURSUANCE OF A PURCHASE OR AGREEMENT TO PURCHASE

I, the undersigned, representing the above name consignee, herewith declare that they are the consignees for CBP purposes of the merchandise described
herein, that the entry covering the said merchandise exhibits a full and complete account of all the merchandise imported by them in the vessel indicated in
the said entry and that the said merchandise was obtained by them in pursuance of a purchase or an agreement to purchase, except as listed below.
16. EXCEPTIONS (IF ANY)

SECTION IV

GENERAL DECLARATION

I also declare, to the best of my knowledge and belief, that all statements appearing in the entry and in the invoice or invoices and other documents
presented herewith and in accordance with which the entry is made, are true and correct in every respect; that the entry and invoices set forth the true
prices, values, quantities, and all information as required by the law and the regulations made in pursuance thereof, that the invoices and other documents
are in the same state as when received; that I have not received and do not know of any other invoices, paper, letter, document, or information showing a
different currency, price, value, quantity, or description of the said merchandise, and that if at any time hereafter I discover any information showing a
different state of facts, I will immediately make the same known to the port director of CBP at the port of entry.
17. SIGNATURE
18. ADDRESS
19. DATE

20. TITLE (CHECK ONE)
PRINCIPAL
MEMBER OF THE FIRM

PRINCIPAL OFFICER OF THE CORPORATION: TITLE

AUTHORIZED AGENT
Paperwork Reduction Act Statement: An agency may not conduct or sponsor an information collection and a person is not required to respond to this
information unless it displays a current valid OMB control number and an expiration date. The control number for this collection is 1651-0093. The estimated
average time to complete this application is 6 minutes. If you have any comments regarding the burden estimate you can write to U.S. Customs and Border
Protection, Office of Regulations and Rulings, 799 9th Street, NW., Washington DC 20229.

CBP Form 3347A (07/14)