APPLICATION FOR
FOREIGN-TRADE ZONE ADMISSION
AND/OR STATUS DESIGNATION
14. STATISTICAL INFORMATION FURNISHED DIRECTLY TO BUREAU OF CENSUS BY APPLICANT?
CBP Form 214A (11/09)
(See page 2 for Paperwork Reduction Act Notice.)
49. DATE
48. TITLE
47. FOR THE FTZ OPERATOR (Signature)
46. To the Port Director of CBP: The above merchandise was received at the Zone on the date shown except as noted below:
45. DATE
44. CHL NO.
43. CARTMAN
42. RECEIVED FOR TRANSFER TO ZONE (Driver's Signature)
41. DATE
40. STATION
39. TITLE
38. CBP OFFICER AT STATION (Signature)
37. The goods described herein are authorized to be transferred:
36. DATE
34. PORT DIRECTOR OF CBP: BY (Signature)
The above merchandise has been
granted the requested status.
33. DATE
32. TITLE
31. PORT DIRECTOR OF CBP: BY (Signature)
30. DATE
29. TITLE
28. FOR THE F.T.Z. OPERATOR (Signature)
27. DATE
26. TITLE
25. BY (Signature)
24. APPLICANT FIRM NAME
11. INBOND CARRIER
12. I.T. NO. AND DATE
13. I.T. FROM (Port)
7. U.S. PORT OF UNLADING
8. FOREIGN PORT OF LADING
9. BILL OF LADING/AWB NO. 10. INWARD M'FEST NO.
3. IMPORTING VESSEL (& FLAG)/OTHER CARRIER
5. IMPORT DATE
4. EXPORT DATE
6. ZONE ADMISSION NO.
2. PORT CODE
1. ZONE NO. AND LOCATION (Address)
OMB No. 1651-0029 Exp. 01-31-2010
PERMIT
35. TITLE
21. HARBOR MAINTENANCE FEE (19 CFR 24.24)
YES
NO
NONPRIVILEGED FOREIGN
(19 CFR 146.42)
without exception
except as noted below
PERMIT
Permission is hereby granted to
transfer the above merchandise
into the Zone.
CENSUS USE ONLY
STATISTICAL COPY
DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
15.
NO. OF
PACKAGES
AND COUNTRY
OF ORIGIN CODE
16.
DESCRIPTION OF MERCHANDISE
17.
HTSUS NO.
18.
QUANTITY
(HTSUS)
19.
GROSS
WEIGHT
20.
SEPARATE
VALUE & AGGR
CHGS.
22. I hereby apply for admission of the above merchandise into the Foreign-Trade Zone. I declare to the best of my knowledge and belief that the above
merchandise is not prohibited entry in the Foreign-Trade Zone within