Form 4457 Certificate of Registration for Personal Effects Taken A

DEPARTMENT OF HOMELAND SECURITY

OMB No. 1651-0010
Exp. 08-31-2009
Number

U.S. Customs and Border Protection
CERTIFICATE OF REGISTRATION
FOR PERSONAL EFFECTS TAKEN ABROAD
19 CFR 148.1
Name of Owner

Address of Owner

Description of Articles

I certify that the information shown hereon
is true and correct to the best of my
knowledge and belief.

Signature of Owner

Port

Signature of CBP Official

Date

Certifying officer shall draw lines through all unused spaces with ink.
CBP Form 4457 (06/92)

Paperwork Reduction Act Notice: The Paperwork Reduction Act requires that we advise
you of the purpose of this form and how the information will be used. The form is provided
for your use, strictly at your option, in lieu of or in addition to bills of sale, appraisals, and/or
repair receipts to show the CBP officer proof of prior possession of the article(s) in the U.S.
The completion of this form by you is strictly voluntary. U.S. Customs and Border
Protection does not maintain copies of the completed forms.
Statement Required by 5 CFR 1320.21: The estimated average burden associated with
this collection of information is 3 minutes per respondent or record keeper depending on
individual circumstances. Comments concerning the accuracy of this burden estimate and
suggestions for reducing this burden should be directed to the U.S. Customs and Border
Protection, Information Services Branch, Washington, DC 20229, and to the Office of
Management and Budget, Paperwork Reduction Project (1651-0010), Washington, DC
20503.

INSTRUCTIONS
1. Complete the Original only.
2. Prior to Departure, present the described articles and the completed form to
a CBP Officer for comparison and signing of the form.
3. The signed form is to be returned to the applicant and must be shown to CBP
each time the registered article(s) are returned.
4. This certificate is not transferable.
5. Note: Foreign repairs or alterations to articles (whether or not the articles are
registered with CBP) are dutiable. Such repairs or alterations must be declared
to Customs when the articles reenter the United States, whether or not they
were done free of charge.
CBP Form 4457 (Back)(06/92)