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Get CBP 7501 2019-2021

41. DECLARANT NAME TITLE 42. Broker/Filer Information Name address phone number SIGNATURE DATE 43. Broker/Importer File No. Paperwork Reduction Act Notice CBP Form 7501 2/18 Page 1 of 5 Net Quantity in HTSUS Units. DEPARTMENT OF HOMELAND SECURITY U*S* Customs and Border Protection OMB APPROVAL NO. 1651-0022 EXPIRATION DATE 01/31/2021 ESTIMATED BURDEN 10 MIN ENTRY SUMMARY 1. Filer Code/Entry No* 2. Entry Type 3. Summary Date 4. Surety No* 5. Bond Type 6. Port Code 7. Entry Date 8. Importing Carrier 9. Mode of Transport 10. Country of Origin 11. Import Date 12. B/L or AWB No* 13. Manufacturer ID 14. Exporting Country 15. Export Date 16. I. T. No* 17. I. T. Date 21. Location of Goods/G*O. No* 18. Missing Docs 22. Consignee No* 25. Ultimate Consignee Name and Address City State Line No* A. HTSUS No* B. ADA/CVD No* Other Fee Summary for Block 39 Zip 23. Importer No* 24. Reference No* A. Entered Value B. CHGS C. Relationship A. Grossweight Net Quantity in B. Manifest Qty. HTSUS Units Total Other Fees 36. DECLARATION OF IMPORTER OF RECORD OWNER OR PURCHASER OR AUTHORIZED AGENT Importer of record and that the actual owner or purchaser or agent thereof* I further declare that the merchandise A. HTSUS Rate B. ADA/CVD Rate C. IRC Rate D. Visa No* CBP USE ONLY 35. Total Entered Value purchaser or consignee for CBP purposes is as shown above OR I declare that I am the 20. U*S* Port of Unlading 26. Importer of Record Name and Address 28. Description of Merchandise 19. Foreign Port of Lading Duty and I. R* Tax Dollars Cents TOTALS A. LIQ CODE B. Ascertained Duty 37. Duty REASON CODE C. Ascertained Tax 38. Tax D. Ascertained Other 39. Other E* Ascertained Total 40. Total owner was obtained pursuant to a purchase or agreement to purchase and that the prices set forth in the invoices are true OR was not obtained pursuant to a purchase or agreement to purchase and the statements in the invoices as to value or price are true to the best of my knowledge and belief* I also declare that the statements in the documents herein filed fully disclose to the best of my knowledge and belief the true prices values quantities rebates drawbacks fees commissions and royalties and are true and correct and that all goods or services provided to the seller of the merchandise either free or at reduced cost are fully disclosed* I will immediately furnish to the appropriate CBP officer any information showing a different statement of facts. DEPARTMENT OF HOMELAND SECURITY U*S* Customs and Border Protection OMB APPROVAL NO. 1651-0022 EXPIRATION DATE 01/31/2021 ESTIMATED BURDEN 10 MIN ENTRY SUMMARY 1. Filer Code/Entry No* 2. Entry Type 3. Summary Date 4. Surety No* 5. Bond Type 6. Port Code 7. Entry Date 8. Filer Code/Entry No* 2. Entry Type 3. Summary Date 4. Surety No* 5. Bond Type 6. Port Code 7. Entry Date 8. Importing Carrier 9. Mode of Transport 10. Country of Origin 11. Import Date 12. B/L or AWB No* 13. Importing Carrier 9. Mode of Transport 10. Country of Origin 11. Import Date 12. B/L or AWB No* 13. Manufacturer ID 14. Exporting Country 15. Export Date 16. I. T. No* 17. I. T. Date 21. Location of Goods/G*O..

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