DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
Entry Summary Number and/or Action Number
Importer of Record 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.
COLLECTION INFORMATION (Complete only if payment attached)
CBP Form 7501 TEST (04/09)