DECLARATION FOR FREE ENTRY OF
RETURNED AMERICAN PRODUCTS
19
CFR 10.1, 10.5, 10.6, 10.67, 12.41, 123.4, 143.23, 145.35, 162.1C
|
1 PORT & DISTRICT |
2. DATE |
3. ENTRY NO. & DATE |
|
|
4. NAME OF MANUFACTURER |
5. CITY AND STATE OF MANUFACTURE |
||
|
6. REASON FOR RETURN |
7. U.S. DRAWBACK PREVIOUSLY
----CLAIMED
----NO CLAIMED |
||
|
8. PREVIOUSLY
IMPORTED TSUSA 864.05?
----YES ---- NO |
|||
|
9. MARKS, NUMBERS, AND DESCRIPTION OF
ARTICLES RETURNED |
10. VALUE
|
||
|
|
|
||
|
If the value of the article is $10,000 or
more and the articles are not clearly marked with the name and address of U.S. manufacturer, please attach copies of art mentation
or other evidence that you have that will support or substantiate your claim
for duty free status as American Goods Returned. |
|||
|
11. I declare that the information given
above is true and correct to the best of my knowledge and belief, that the articles described above are the growth
production and manufacture of the United States and are returned without
having been advanced in value or improved in condition by any process of
manufacture or other means, that no drawback bounty or allowance has been paid or admitted thereon, or on any part thereof, and that if any notice(s) of exportation of articles with benefit of
drawback --- was ---were filed upon exportation of the
merchandise from the United States, such notice(s) ---has ---have been abandoned. |
|||
|
12. NAME OF DECLARANT |
13. TITLE OF DECLARANT |
||
|
14. NAME OF CORPORATION OR PARTNERSHIP (if
any) |
15. SIGNATURE (See note) |
||
|
If the owner or
ultimate consignee is a corporation, the form must be signed
by the president, vice president, secretary, or treasurer of the corporation any employee or agent of the
corporation who holds a power of attorney and a certificate by the
corporation that such employee or agent has or will have knowledge of the pertinent facts. |
|||
|
Notice required by Paperwork Reduction Act of
1980. This information is needed to ensure that importers/exporters are complying with U.S. customs laws to us to compute and collect the right
amount of money, to enforce other agency requirements, and to collect accurate statistical information on imports response is mandatory. |
|||
Customs Form 3311 (112084)
U.S. GPO 1987-742-011/41134