OMB 1651-0075 Exp. 10/31/2011
Certificate of Delivery
1. CM&D No.
2. Port
Code
3. DBK Ruling No.
DELIVERY CERTIFICATE FOR PURPOSES OF DRAWBACK
4. Type
Code
5. ID No. of Transferor
RECEIVED DATE
7. TO TRANSFEREE:
6. FROM TRANSFEROR:
Company Name and Complete Address
IMPORTED DUTY PAID, DESIGNATED MERCHANDISE OR DRAWBACK PRODUCT
20. Total
PREPARER
21. Contact Name and Address
Phone Number
Ext.
FAX Number
19 CFR 191
Company Name and Complete Address
CBP Form 7552 (07/08)
DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
PAPERWORK REDUCTION ACT NOTICE: This request is in accordance with the Paperwork Reduction Act. We ask for the information in
order to carry out U.S. Department of Homeland Security laws and regulations, to determine the eligibility for refund of taxes on domestic alcohol (if
applicable), and to determine the proper amount of drawback. Your response is required to obtain or retain a benefit. The estimated average burden
associated with this collection of information is 33 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 (1651-0075) Washington, DC 20503.
10.
Port
Code
11.
Import
Date
(MM/DD/YYYY)
12.
CD
13. (If using 1313(b))
A. B.
Date(s) Date(s)
Received Used
14.
Date
Delivered
15.
HTSUS
No.
16.
Description of Merchandise
(Include Part/Style/Serial Numbers)
17.
Quantity
&
Unit of
Measure
8.
Use
18.
Entered
Value
Per Unit
19.
100%
Duty
Certificate
of
Manufacture
and
Delivery
9.
Import Entry
or
CM&D Number
22.
Quantity & Description
of Merchandise Used
30. Exhibits to be attached for the following:
Waste
Calculation
Harbor Maint