Form ITA-4141P Steel Import License

Steel Import License
IMPORT ADMINISTRATION

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Valid for use on ONE Customs Entry ONLY

ITA Form: 4141P

OMB Form: 0625-0245
Expire: June 30, 2008

How to Fill out License Form

STEEL IMPORT LICENSE
(All fields are required except Customs Entry Number, License Number, and those for Product Two-Ten.)

** Printer-Friendly Format Available after Form is Submitted **
Foreign Trade Zone
1) Applicant Company:

2) Customs Entry Number:

3) License Number:

4) Contact Name:

5) Address of Applicant:
,,

6) Contact Phone:

7) Contact Fax:

8) Contact Email:

9) Importer Name:

10) Exporter Name:

11) Manufacturer Name:

12) Country of Origin (Customs Basis):
---- Please select from list ----

13) Country of Exportation:
---- Please select from list ----

14) Expected Port of Entry:
---- Please select from list ----

15) Expected Date of Export (mm/dd/yyyy):

16) Expected Date of Importation (mm/dd/yyyy):

17) Date License Valid From:
11/15/2007

18) Date License Valid Through:
01/29/2008

19) Date of Application:
11/15/2007

PRODUCT ONE
20) HTS Number:
---- Please select from list ---21) Product Description:

23) Volume (Quantity in Kilograms):

22) Category:

24) Unit:

25) Entered Value (U.S.$):

26) Unit Value ($/mt):

$

$

PRODUCT TWO
27) HTS Number:
---- Please select from list ---28) Product Description:

30) Volume (Quantity in Kilograms):

29) Category:

31) Unit:

32) Entered Value (U.S.$):

33) Unit Value ($/mt):

$

$

PRODUCT THREE
34) HTS Number:
---- Please select from list ---35) Product Description:

37) Volume (Quantity in Kilograms):

36) Category:

38) Unit:

39) Entered Value (U.S.$):

40) Unit Value ($/mt):

$

$

PRODUCT FOUR
41) HTS Number:
---- Please select from list ---42) Product Description:

44) Volume (Quantity in Kilograms):

43) Category:

45) Unit:

46) Entered Value (U.S.$):

47) Unit Value ($/mt):

$

$

PRODUCT FIVE
48) HTS Number:
---- Please select from list ---49) Product Description:

51) Volume (Quantity in Kilograms):

50) Category:

52) Unit:

53) Entered Value (U.S.$):

54) Unit Value ($/mt):

$

$

PRODUCT SIX
55) HTS Number:
---- Please select from list ---56) Product Description:

68) Volume (Quantity in Kilograms):

67) Category:

69) Unit:

60) Entered Value (U.S.$):

61) Unit Value ($/mt):

$

$

PRODUCT SEVEN
62) HTS Number:
---- Please select from list ---63) Product Description:

65) Volume (Quantity in Kilograms):

64) Category:

66) Unit:

67) Entered Value (U.S.$):

68) Unit Value ($/mt):

$

$

PRODUCT EIGHT
69) HTS Number:
---- Please select from list ---70) Product Description:

72) Volume (Quantity in Kilograms):

71) Category:

73) Unit:

74) Entered Value (U.S.$):

75) Unit Value ($/mt):

$

$

PRODUCT NINE
76) HTS Number:
---- Please select from list ---77) Product Description:

79) Volume (Quantity in Kilograms):

78) Category:

80) Unit:

81) Entered Value (U.S.$):

82) Unit Value ($/mt):

$

$

PRODUCT TEN
83) HTS Number:
---- Please select from list ---84) Product Description:

86) Volume (Quantity in Kilograms):

85) Category:

87) Unit:

88) Entered Value (U.S.$):

89) Unit Value ($/mt):

$

$

Before submitting this form to the Department of Commerce, you must check the box below to certify that, as a representative of the manufacturer or importer, the above
information is accurate and complete to the best of your knowledge.

I certify that the above information is accurate and complete to the best of my knowledge. I also understand that certain information on this license regarding volume
(or quantity), value and country of origin will be posted on public website aggregated with similar data from other licenses.

Public reporting for this collection of information is estimated to be 10 minutes per response, including the time for reviewing instructions, and completing and reviewing
the collection of information. All responses to this collection of information are required, and will be provided confidentially to the extent allowed by law. Notwithstanding
any other provision of law, no person is required to respond to nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. Send comments regarding the burden
estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Clearance Officer, International Trade
Administration, Department of Commerce, Room 4001, 14th and Constitution Avenue, N.W., Washington, D.C. 20230.

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