Form 1303 Ship's Stores Declaration

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection

SHIP'S STORES DECLARATION
Arrival

Page No.

Departure

19 CFR 4.7, 4.7a, 4.81, 4.85, 4.87
1. Name of Ship

2. Port of arrival/departure

4. Nationality of ship

5. Port arrived from/Port of destination

6. Number of persons on board
9. Name of article

7. Period of stay
10. Quantity

OMB No.1651-0018
Exp. 06-30-2011

3. Date of arrival/departure

8. Place of storage*
11. For Official Use

12. Date and signature by master, authorized agent or officer
This form may be printed by private parties provided the supply printed conforms to the
official form in size, wording, arrangement, and quality and color of paper.

*Not required by the United States

Paperwork Reduction Act Statement: An agency may not conduct or sponsor an information collection and a person is not required to respond to this information unless it
displays a current valid OMB control number and an expiration date. The control number for this collection is 1651-0018. The estimated average time to complete this
application is 15 minutes. If you have any comments regarding the burden estimate you can write to U.S. Customs and Border Protection, Office of Regulations and Rulings,
799 9th Street, NW., Washington DC 20229.

CBP Form 1303 (06/09)