Form 3173 Application for Extension of Bond for Temporary Importat

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection

Form Approved
OMB No. 1651-0015
Exp. 08-31-2012

APPLICATION FOR EXTENSION OF BOND
FOR TEMPORARY IMPORTATION
19 U.S.C. 66, 1202; 19 CFR 10.37
(Chap. 98, Subchapter XIII, Harmonized Tariff Schedules of the United States)
1. NAME AND ADDRESS OF IMPORTER

2. TIB ENTRY NUMBER

3. DATE OF THIS REQUEST

4. DESCRIPTION OF MERCHANDISE

5. TARIFF ITEM NUMBER

6. DATE OF IMPORTATION

7. NUMBER AND DURATION OF
PREVIOUS EXTENSIONS

8. DATE TO WHICH THIS EXTENSION IS
REQUESTED (NOT TO EXCEED 3
YEARS FROM DATE OF IMPORTATION)

9. REASON FOR APPLICATION (State why goods have not been exported or destroyed within the original bond period of authorized extension.)

10. DESCRIBE BRIEFLY ALL USES TO WHICH THE ARTICLES HAVE BEEN PUT SINCE IMPORTATION

11. DESCRIBE BRIEFLY ALL USES TO WHICH THE ARTICLES WILL BE PUT DURING THE PERIOD OF EXTENSION

12. HAVE THE ARTICLES BEEN OFFERED FOR SALE OR SALE ON APPROVAL

THIS BLOCK FOR CBP USE ONLY
DATE
APPLICATION
APPROVED

PORT DIRECTOR
BY:

YES

(Give details below)

NO

13. I DECLARE THAT ALL THE FACTS STATED ABOVE ARE TRUE AND
ACCURATE IN ALL RESPECTS.

(SIGNATURE)

(TITLE)

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 1651-0015. The estimated average time to complete this application is 13 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 3173 (05/06)