DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
DOCUMENT/PAYMENT TRANSMITTAL
(7501) Importer of Record Number
Entry Summary Number and/or Action Number Entry Date 05/27/2009
Summary Date Team Number
This form is in "Test" status for a specified time to collect comments for further action. It is for testing purposes only and not to be reproduced at this time. The final product could have a 2D Barcode in this field for data collection.
Code (001) Duty (499) MPF (501) HMF ( ) ( ) ( ) ( ) Comments:
COLLECTION INFORMATION (Complete only if payment attached) Amount
TOTAL
CBP Form 7501 TEST (04/09)