Free CBP Form 3461 - Entry/Immediate Delivery - Federal

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection ENTRY/IMMEDIATE DELIVERY
19 CFR 142.3, 142.16, 142.22, 142.24
1. ARRIVAL DATE 5. PORT 2. ELECTED ENTRY DATE 3. ENTRY TYPE CODE/NAME 6. SINGLE TRANS. BOND 8. CONSIGNEE NUMBER 10. ULTIMATE CONSIGNEE NAME 11. IMPORTER OF RECORD NAME 7. BROKER/IMPORTER FILE NUMBER

Form Approved OMB No. 1651-0024 Exp. 01-31-2012

4. ENTRY NUMBER

9. IMPORTER NUMBER

12. CARRIER CODE 15. VESSEL CODE/NAME 16. U.S. PORT OF UNLADING 20. DESCRIPTION OF MERCHANDISE 21. IT/BL/AWB CODE 22. IT/BL/AWB NO.

13. VOYAGE/FLIGHT/TRIP 14. LOCATION OF GOODS-CODE(S)/NAME(S)

17. MANIFEST NUMBER

18. G.O. NUMBER

19. TOTAL VALUE

23. MANIFEST QUANTITY

24. H.S. NUMBER

25. COUNTRY OF ORIGIN

26. MANUFACTURER NO.

27. CERTIFICATION
I hereby make application for entry/immediate delivery. I certify that the above information is accurate, the bond is sufficient, valid, and current, and that all requirements of 19 CFR Part 142 have been met. SIGNATURE OF APPLICANT

28. CBP USE ONLY
OTHER AGENCY ACTION REQUIRED, NAMELY:

X
PHONE NO. DATE 29. BROKER OR OTHER GOVT. AGENCY USE CBP EXAMINATION REQUIRED. ENTRY REJECTED, BECAUSE:

SIGNATURE DELIVERY AUTHORIZED:

DATE

PAPERWORK REDUCTION ACT NOTICE: This information is to determine the admissibility of imports into the United States and to provide the necessary information for the examination of the cargo and to establish the liability for payment of duties and taxes. Your response is necessary. The estimated average burden associated with this collection of information is 15 minutes per respondent depending on individual circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to U.S. Customs and Border Protection, Asset Management, Washington, DC 20229, and to the Office of Management and Budget, Paperwork Reduction Project (1651-0024), Washington, DC 20503.

CBP Form 3461 (01/09)