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pdfDEPARTMENT OF HOMELAND SECURITY
OMB No. 1651-0024
Exp. 08-31-2018
U.S. Customs and Border Protection
ENTRY/IMMEDIATE DELIVERY
19 CFR 142.3, 142.16, 142.22, 142.24, 149.3
HEADER INFORMATION
1. PORT OF ENTRY:
2. BOND TYPE:
Single Transaction Bond
Continuous Bond
No Bond Required
3. IMPORTER NUMBER:
SSN
IRS
CBP Assigned
4. IMPORTER NAME AND ADDRESS:
5. ENTRY NUMBER:
6. BOND VALUE:
7. ENTRY VALUE:
8. CES:
9. ENTRY TYPE:
10. ORIGINATING WHSE ENTRY NUMBER (For Entry Type 22 Only):
12. PORT OF UNLADING:
13. MODE OF TRANSPORTATION:
Ocean
Rail
Air
Hand Carry
15. G.O. NUMBER:
Pipeline
11. SURETY CODE:
14. LOCATION OF GOODS (FIRMS):
Truck
Other
16. CONVEYANCE NAME/FTZ ZONE ID:
HEADER REFERENCE INFORMATION
17. REFERENCE ID CODE:
18. REFERENCE ID NUMBER (UP TO 50 CHARACTERS):
HEADER PARTIES (MUST APPLY TO ENTIRE ENTRY; IF NOT, SKIP TO LINE INFORMATION
19. HEADER PARTY TYPE:
20. HEADER PARTY TYPE NAME/ADDRESS
21. HEADER ID #, IF APPLICABLE
Manufacturer
Consignee
Buying Party
Selling Party
IRS
SSN
CBP Assigned
Manufacturer
Consignee
Buying Party
Selling Party
IRS
SSN
CBP Assigned
Manufacturer
Consignee
Buying Party
Selling Party
IRS
SSN
CBP Assigned
Manufacturer
Consignee
Buying Party
Selling Party
IRS
SSN
CBP Assigned
22. CERTIFICATION
23. CBP USE ONLY
I hereby make application for entry/immediate delivery. I certify that the
above information is accurate, the bond is sufficient, valid, and current,
and that all requirements of 19 CFR Part 142 have been met.
OTHER AGENCY ACTION REQUIRED, NAMELY:
SIGNATURE OF APPLICANT:
PHONE NUMBER:
DATE:
BROKER OR OTHER GOVT. AGENCY USE
CBP EXAMINATION REQUIRED.
ENTRY REJECTED, BECAUSE:
DELIVERY
AUTHORIZED:
SIGNATURE:
DATE:
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 1651-0024. The
estimated average time to complete this application is 15 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, 90 K Street, NE, Washington DC 20229.
CBP Form 3461 (02/16)
24. LINE INFORMATION
LINE 1 HTS CODE:
1.
HTS / COMMERCIAL / DESCRIPTION:
HTS
Commercial/Invoice
2.
Description:
COUNTRY OF ORIGIN:
Manufacturer
Consignee
FTZ FILING DATE:
ZONE STATUS:
LINE PARTY TYPE:
LINE ITEM QUANTITY:
P
LINE ID NUMBER, IF APPLICABLE:
Buying Party
Selling Party
LINE 2 HTS CODE:
1.
HTS / COMMERCIAL / DESCRIPTION:
HTS
Commercial/Invoice
2.
Description:
Manufacturer
Consignee
IRS
SSN
LINE ITEM QUANTITY:
VALUE:
1.
FTZ FILING DATE:
ZONE STATUS:
LINE PARTY TYPE:
P
LINE 3 HTS CODE:
1.
HTS / COMMERCIAL / DESCRIPTION:
HTS
Commercial/Invoice
2.
Description:
Manufacturer
Consignee
IRS
SSN
LINE ITEM QUANTITY:
VALUE:
1.
FTZ FILING DATE:
ZONE STATUS:
P
LINE 4 HTS CODE:
1.
HTS / COMMERCIAL / DESCRIPTION:
HTS
Commercial/Invoice
2.
Description:
Manufacturer
Consignee
2.
LINE ID NUMBER, IF APPLICABLE:
Buying Party
Selling Party
IRS
SSN
LINE ITEM QUANTITY:
VALUE:
1.
FTZ FILING DATE:
ZONE STATUS:
LINE PARTY TYPE:
CBP Assigned
N
LINE NAME/ADDRESS:
COUNTRY OF ORIGIN:
2.
LINE ID NUMBER, IF APPLICABLE:
Buying Party
Selling Party
LINE PARTY TYPE:
CBP Assigned
N
LINE NAME/ADDRESS:
COUNTRY OF ORIGIN:
2.
N
LINE NAME/ADDRESS:
COUNTRY OF ORIGIN:
VALUE:
1.
P
CBP Assigned
2.
N
LINE NAME/ADDRESS:
LINE ID NUMBER, IF APPLICABLE:
IRS
Buying Party
Selling Party
SSN
CBP Assigned
BILL OF LADING INFORMATION (Use additional block below for a second Bill of Lading)
25.
Non-AMS
26.
Split Bill
29. IN-BOND NUMBER:
SECOND BILL OF LADING
IN-BOND NUMBER:
33. VOYAGE/FLT/TRIP:
27. BOL TYPE:
In-Bond
Master
30. BOL NUMBER:
BOL TYPE:
In-Bond
House
Regular/Simple
31. QUANTITY:
Master
BOL NUMBER:
34. CONVEYANCE:
House
Regular/Simple
QUANTITY:
28. SCAC/CARRIER ID:
32. UNIT OF MEASURE:
SCAC/CARRIER ID:
UNIT OF MEASURE:
35. ARRIVAL DATE:
CBP Form 3461 (02/16)
File Type | application/pdf |
File Modified | 2016-02-19 |
File Created | 2016-02-19 |