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pdfOMB No. 1651-0106
Exp. 08-31-2011
APPLICATION TO PAY OFF or
DISCHARGE ALIEN CREWMAN
DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
To be filed in triplicate. See instructions on reverse.
ARRIVAL MANIFEST FILED AT (PORT):
I. CARRIER:
DATE OF ARRIVAL:
I hereby request authorization to pay off/discharge the alien crewmen listed below.
II.
NAME IN FULL
FAMILY NAME
GIVEN NAME AND
MIDDLE INITIAL
NATIONALITY AND
PASSPORT NUMBER
ACTION BY CBP
NOTE: IF ADDITIONAL SPACE IS REQUIRED, ATTACH LIST IN TRIPLICATE.
III. REASON FOR REQUEST:
IV. ARRANGEMENTS FOR DEPARTURE FROM THE U.S. OF THE LISTED CREWMEN AND DATE AND PORT OF DEPARTURE, AIR CARRIER
AND FLIGHT NUMBER OR VESSEL.
MAILING ADDRESS OF CARRIER:
SIGNATURE
TITLE
FOR GOVERNMENT USE ONLY
APPLICATION:
OFFICE:
GRANTED
DENIED
COPY:
MAILED
DATE:
SIGNATURE:
SIGNATURE:
TITLE:
TITLE:
DATE:
DELIVERED
CBP Form I-408 (06/09)
OMB No. 1651-0106
Exp. 08-31-2011
APPLICATION TO PAY OFF or
DISCHARGE ALIEN CREWMAN
DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
To be filed in triplicate. See instructions on reverse.
ARRIVAL MANIFEST FILED AT (PORT):
I. CARRIER:
DATE OF ARRIVAL:
I hereby request authorization to pay off/discharge the alien crewmen listed below.
NAME IN FULL
II.
FAMILY NAME
GIVEN NAME AND
MIDDLE INITIAL
NATIONALITY AND
PASSPORT NUMBER
ACTION BY CBP
NOTE: IF ADDITIONAL SPACE IS REQUIRED, ATTACH LIST IN TRIPLICATE.
III.
REASON FOR REQUEST:
IV.
ARRANGEMENTS FOR DEPARTURE FROM THE U.S. OF THE LISTED CREWMEN AND DATE AND PORT OF DEPARTURE, AIR CARRIER
AND FLIGHT NUMBER OR VESSEL.
MAILING ADDRESS OF CARRIER:
SIGNATURE
TITLE
FOR GOVERNMENT USE ONLY
APPLICATION:
OFFICE:
GRANTED
DENIED
COPY:
MAILED
DATE:
SIGNATURE:
SIGNATURE:
TITLE:
TITLE:
DATE:
DELIVERED
CBP Form I-408 (06/09)
OMB No. 1651-0106
Exp. 08-31-2011
APPLICATION TO PAY OFF or
DISCHARGE ALIEN CREWMAN
DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
To be filed in triplicate. See instructions on reverse.
ARRIVAL MANIFEST FILED AT (PORT):
I. CARRIER:
DATE OF ARRIVAL:
I hereby request authorization to pay off/discharge the alien crewmen listed below.
NAME IN FULL
II.
FAMILY NAME
GIVEN NAME AND
MIDDLE INITIAL
NATIONALITY AND
PASSPORT NUMBER
ACTION BY CBP
NOTE: IF ADDITIONAL SPACE IS REQUIRED, ATTACH LIST IN TRIPLICATE.
III.
REASON FOR REQUEST:
IV.
ARRANGEMENTS FOR DEPARTURE FROM THE U.S. OF THE LISTED CREWMEN AND DATE AND PORT OF DEPARTURE, AIR CARRIER
AND FLIGHT NUMBER OR VESSEL.
MAILING ADDRESS OF CARRIER:
SIGNATURE
TITLE
FOR GOVERNMENT USE ONLY
APPLICATION:
OFFICE:
GRANTED
DENIED
COPY:
MAILED
DATE:
SIGNATURE:
SIGNATURE:
TITLE:
TITLE:
DATE:
DELIVERED
CBP Form I-408 (06/09)
NOTICE
SECTION 256 OF THE IMMIGRATION AND NATIONALITY ACT (8 USC 1286)
Note: The authorities and responsibilities of the Attorney General now be long to the Secretary of Homeland Security
It shall be unlawful for any person, including the owner, agent consignee, charterer, master or commanding officer vessel
or aircraft, to pay off or discharge an alien crewman, except an alien lawfully admitted for permanent residence, employed
on board a vessel or aircraft arriving in the United States without first having obtained the consent of the Attorney General.
If it shall appear to the satisfaction of the Attorney General that any alien crewman has been paid off or discharged in the
United States in violation of the provisions of this section, such owner, agent, consignee, charterer, master, commanding
officer or other person, shall pay to the Commissioner the sum of $3,000 for each such violation. No vessel or aircraft
shall be granted clearance pending the determination of the question of the liability to the payment of such sums or while
such sums remain unpaid, except that clearance may be granted prior to the determination of such question of the liability
to the payment of such sums or while such sums remain unpaid, except that clearance may be granted prior to the
determination of such question upon the deposit of an amount sufficient to cover such sums, or of a bond approved by the
commissioner with sufficient surety to secure the payment thereof. Such fine may, in the discretion of the Attorney
General be mitigated to not less than $1,500 for each violation, upon such terms as he shall think proper.
INSTRUCTIONS
1. Filing - The application must be completed in triplicate and delivered or mailed to the nearest office of U.S. Customs
and Border Protection (CBP).
2. Execution - The signature and title of either the owner, agent, consignee, charterer, master or commanding officer of
the vessel or aircraft seeking authorization to pay off or discharge crewmen must be included on the application.
3. General - Inadequate or incomplete data required in items III, Reason for request, and IV, Arrangements for departure,
may result in denial of the application.
4. Disposition - The original and one copy of the granted application will be returned to the applicant. The copy must be
submitted with the departure manifest. One copy of the application will be retained by CBP with the arrival manifest.
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 1651-0106. The estimated average time to complete this application is 25 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 I-408 (Back)(06/09)
| File Type | application/pdf |
| File Modified | 2009-06-22 |
| File Created | 2009-06-22 |