Get CBP 5106 2020

TYPE OF ACTION CBP Form 5106 QR Code can be scanned to link this form to your smartphone or mobile operating device. 5 authorizes the disclosure of Social Security numbers SSN on the CBP Form 5106 and implements CBP s authority to collect the taxpayer identification number and SSN as provided for in 31 U.S.C. 1J thru 1M - If you are currently an active participant in a CBP Partnership Program s please provide the program code in Block 1J thru Block 1M of the revised CBP Form 5106 and the information that is contained in Section 3 of the revised CBP Form will not be required. ex. If you are also a broker/self-filer supply the filer code that will be used when conducting business with CBP CBP Form 5106 6/17 Page 1 of 4 3E. Year established 3F. List the names and Internal Revenue Service IRS employer identification Social Security or CBP-assigned numbers for current or previous related business entities. I understand that if I make an intentional false statement or commit deception or fraud in this 5106 document I may be fined or imprisoned 18 U.S.C. U*S* Customs and Border Protection OMB APPROVAL NO. 1651-0064 EXPIRATION DATE 01-31-2018 ESTIMATED BURDEN 45 MIN* CREATE/UPDATE IMPORTER IDENTITY FORM 19 CFR 24. 5 As the importer consignee or other party listed in block 1 you are responsible for the validity of the information provided in this document. Any Customs Broker or third party who is submitting the information on your behalf is only obligated to convey this information to Customs and Border Protection CBP. TYPE OF ACTION Mark all applicable Notification of identification number 1. NAME AND IDENTIFICATION NUMBER 1A. Importer/Business/Private Party Name 1C. DIV AKA Change of name Change of address 1B. Internal Revenue Service IRS number/Social Security Number SSN 1D. DIV/AKA/DBA Name DBA 1E* I wish to be assigned a CBP Number. Check here if requesting a CBP-assigned number and indicate reason s. Check all reasons that apply. I have no IRS I have a SSN but wish to use a I have no Social I have not applied for I am not a Number CBP-Assigned Number on all my Security Number an IRS number or SSN U*S* Resident entry documents 1F* CBP-Assigned Number 1G* Type of Company U*S* Government Corporation Partnership LLC Sole Proprietorship State/Local Government Foreign Government Individual 1-5 per year 1H. If you are an importer how many entries do you plan on filing in a year Please select from the following 25 or more per year infrequent personal shipments or I do not intend to import. 1I. How will the identification number be utilized Please select all options that will apply Consignee/Ultimate Consignee Drawback Claimant Refunds/Bills or 1J* Program Code 1 1K. Program Code 2 Importer of Record Other 2. ADDRESS INFORMATION 2A. MAILING ADDRESS Street Address 1 City State/Province Zip Code Country ISO Code Corporate Office Warehouse Is the address in 2A a Residence Business Service Center Post Office Box or Other - Explain Retail Location Office Building 2B.