Form 1304 Crew's Effects Declaration

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection

CREW'S EFFECTS DECLARATION

OMB 1651-0020
Exp. 03-31-2015
Page No.

19CFR 4.7(a), 4.7a(b)
1. Name of ship

3. No.

2. Nationality of ship

4. Family name, given name

5. Rank or rating

6. Articles acquired abroad by officers and
members of the crew (except those exclusively
for use on voyage or cleared through U.S.
Customs and Border Protection authorities)

7. No. of crewmember's
declaration of articles
intended to be landed
(if none, show "NONE"
opposite name)

8. Date and signature by master, authorized agent or officer
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 1651-0020. The estimated
average time to complete this application is 60 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 1304 (06/09)