OMB No. 1651-0013

ENTRY AND MANIFEST OF MERCHANDISE FREE OF DUTY, CARRIER'S CERTIFICATE AND RELEASE

1. NO.

19 U.S.C. 1433, 1484, 1498; 19 CFR 123.4, 143.23

The undersigned, as the importer of merchandise described below, which arrived at the port or station identified, hereby claims free entry therefore under the provisions of the applicable law indicated.

2. PORT CODE

3. DATE

4. VESSEL OR OTHER CONVEYANCE

5. ARRIVAL DATE

6. COUNTRY OF EXPORTATION

7.
MARKS AND NUMBERS

9.
VALUE

10.
HTSUS HEADING NO. OR P.L. NO.

12. AGENT'S SIGNATURE

11. IMPORTER OF RECORD (Name and Address)

13. INSPECTED AND PASSED FREE OF DUTY BY:

14. OWNER, PURCHASER, OR CONSIGNEE (If different from Importer of Record)

16. DATE

15. SIGNATURE (Inspector)

CARRIER'S CERTIFICATE AND RELEASE ORDER

The undersigned carrier, to whom or upon whose order the articles described above must be released, hereby certifies that the person or firm named above as the importer is the owner purchaser, or consignee of such articles within the purview of section 484(h), Tariff Act of 1930. In accordance with the provisions of section 484(j), Tariff Act of 1930, authority is hereby given to release the articles to such consignee.

18. AGENT'S SIGNATURE

17. CARRIER

8.
DESCRIPTION AND QUANTITY OF MERCHANDISE

(mm/dd/yyyy)

(mm/dd/yyyy)

(mm/dd/yyyy)

 U S DEPARTMENT OF HOMELAND SECURITY Bureau of Customs and Border Protection Entry and Manifest of Merchandise Free of Duty, Carrier's Certificate and Release. 19 U S C 1433, 1484, 1498; 19 C F R 123.4, 143.23 O M B Number 16 51-0013 Any data typed after screen scrolls will not print. The undersigned, as the importer of merchandise described below, which arrived at the port or station identified, CARRIER'S CERTIFICATE AND RELEASE ORDER hereby claims free entry therefor under the provisions of the applicable law indicated. The undersigned carrier, to whom or upon whose order the articles described above must be released, hereby certifies that the person or firm named above as the importer is the owner purchaser, or consignee of such articles within the purview of section 4 8 4(h), Tariff Act of 19 30. In accordance with the provisions of section 4 8 4(j), Tariff Act of 19 30, authority is hereby given to release the articles to such consignee.

CBP Form 7523 (05/96)

Customs Form 75 23 (05/96)

Form Page
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U.S. DEPARTMENT OF HOMELAND SECURITY

Bureau of Customs and Border Protection

Any data typed after screen scrolls will not print.