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Signed. In accordance with Title 19 U.S.C. 1618; CFR 171.1. I request U.S. Customs and Border Protection consider my petition for remission or mitigation from forfeiture administratively in order to obtain the release of my property. PART I Seizure or Penalty Number Date of Seizure Place of Seizure Full Name (First, Middle, Last) Address Telephone Number PART II Instructions: Provide certified copies (or originals) of all bills of sale, purchase contracts, receipts, or any other documentar.

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