Form 7553 Notice of Intent to Export/Destroy Merchandise

OMB No. 1651-0075 Exp. 10/31/2011
PAPERWORK REDUCTION ACT NOTICE: This request is in accordance with the Paperwork Reduction Act. We

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection
NOTICE OF INTENT TO EXPORT, DESTROY OR RETURN
MERCHANDISE FOR PURPOSES OF DRAWBACK
19 CFR 191

ask for the information in order to enforce the laws of the United States, to fulfill the U.S. Customs Regulations, to ensure
that the claimant is entitled to drawback, and to have the necessary information which permits CBP to calculate and refund
(or increase) the correct amount of duty and/or tax. Your response is required to obtain a benefit. The estimated average
burden associated with this collection of information is 33 minutes per respondent depending on individual circumstances.
Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to
U.S. Customs and Border Protection, Asset Management, Washington, DC 20229, and to the Office of Management and
Budget, Paperwork Reduction Project (1651-0075) Washington, DC 20503.

2. Drawback Entry No.

1. Exporter or Destroyer

3. Intended Action

Name

Export

4. Intended Date of
Action (MM/DD/YYYY)

Destroy
DATE RECEIVED

6. Contact Name

Address

5. Drawback Center

Address
I.D. Number

Phone

Ext.

FAX
7. Location of Merchandise

15. Import Entry No.

8. Method of
Destruction

9. Location of
Destruction

10. Exporting Carrier Name
(if known)

16. Description of Merchandise (Include Part/Style/Serial Numbers)

11. Intended Port of Export

12. Unique Identifier No.

13. T & E No.

14. Country of Ultimate Destination

17. Drawback Amount

18. Quantity & Unit of Measure
19. HTSUS No./Schedule B

20. Drawback to be filled as:

Rejected Merchandise

Unused Merchandise Drawback
J1
J2
Manufacturing Drawback

Same Condition Drawback under NAFTA

Shipped without Consent

Distilled Spirits, Wine or Beer
under 26 U.S.C. 5062 (c)

Defective at Time of Importation
Not Conforming to Sample or Specifications

21. Preparer

X
Printed Name

Signature

Date

Title

THIS FORM MUST BE
SUBMITTED WITH THE
DRAWBACK CLAIM

CBP USE ONLY
22. Examination

Required or

Waived 25. Printed Name

(Additional information may be required if exam
requested, T & E may be required)

29. Comments/Results of Examination or Witnessing of Destruction. (Merchandise
matches invoice description)

Phone Number

23. Present Merchandise to CBP at:

26. Signature & Badge No.

30. Date Destroyed or Exam Conducted
31. Printed Name of Examining Officer

X
24. Destruction to be Witnessed by
Yes
No
Customs

27. Date

32. Signature & Badge No.

X
28. Port

Phone Number
Ext

Date

CBP Form 7553 (07/08)