Form ITA-4141P Request for a Low-Valued Steel Import License Number

OMB Control No. 0625-0245

Expiration Date: 09/30/2011

Request for a Low-Valued Steel Import License Number

I, (name) , of (company name or on behalf of company xx) , hereby request the Import Administration of the U.S. Department of Commerce, to grant me a multiple-use Steel Import License number for low-valued shipments. I understand that there are certain terms of agreement set in place for the use of the Low-Valued Steel Import License. I understand that once I am granted a license number I will be obliged to adhere to the following the terms of agreement.

I understand that I may use this number more than once, but this license is only valid for covered steel products with a value of $5000 or less per entry.

I understand that this license number may only be used by the company I represent.

I understand all information provided to the Bureau of Customs and Border Protection (CBP) in connection with this license number will be monitored by both CBP and Commerce.

I understand that the misuse of this license may result in the inability of my company to use the low-value license and/or the imposition of CBP enforcement action as appropriate.

Signature Date

Title

Company Name

Company address & phone number

USER ID in the steel license system ___________________________________________

NOTE: Public reporting for this collection of information is estimated to be 5 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 currently 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.