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

ITA NO: ITA-4141P

INTERNATIONAL TRADE ADMINISTRATION
LOW VALUE STEEL IMPORT LICENSE

OMB NO: 0625-0245
Expiration Date: xx/xx/xxxx

Date: 06/13/2011

Steel Import License
Import Administration
US Department of Commerce
1401 Constitution Ave. NW
Washington DC, 20230
Fax: (202) 501-1377

Request for a Low-Value Steel Import License Number

I, of on behalf of , 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.

Attorney In Fact

Applicant
Company:
Contact Name:
Address of
Applicant:
Contact Phone:
Contact Fax:
Contact Email:
Before submitting this form to the Department of Commerce, you must check the box below to certify that, as a representative of
the Manufacturer or importer, the above information is accurate and complete to the best of your knowledge.
I certify that the above information is accurate and complete to the best of my knowledge.
Public reporting for this collection of information is estimated to be 10 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 current 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.

HISTORY