Application to Use Automated Commercial Environment (ACE)

Application
AUTOMATED COMMERCIAL ENVIRONMENT (ACE) SECURE DATA PORTAL
ACCOUNT OWNER DESIGNATION/AUTHORIZATION FORM
Submit this completed document to U.S. Customs and Border Protection (CBP) by providing the requested information in the spaces below. This form
constitutes your company's formal request to access its data via the ACE Secure Data Portal and its designation of an Account Owner (the individual responsible
for the daily administration of the Account's activities).
PLEASE NOTE: With the exception of the required signatures, this form must be typed or printed. Failure to complete all required information will
delay the processing of your application.
By signing below and accessing the ACE Secure Data Portal, the Account Owner agrees to be bound by the terms and conditions of portal access as specifically
set forth in the Terms and Conditions document (see 72 FR 27692, published May 16, 2007) and any applicable Federal Register Notices (FRNs), including
subsequent modifications to currently existing FRNs, as they may relate to the ACE test.
If submitting this form electronically, please click both boxes in section D at the end of this form. This indicates your authorization/approval of the information
contained in this document. This will act as your electronic signatures. Please Note: If you elect to submit this document electronically, you are reminded that
you will be transmitting this information via the public Internet. Data will be sent to the CBP via e-mail. Only use your business e-mail noted on this form to submit
your application. To send, click the "Submit by E-mail" button at the bottom of this form after you have completed the required sections.
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 1651-0105. The estimated
average time to complete this application is 20 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 Exp. 08-31-12
If this is a change to an active account, please specify:

Please note that the processing of your account will be delayed by 2-3 weeks due to mail process.

Section A. Account Information
Account's Fiscal
Year End Date:

Name of Company:

Name of Company Officer:
(include middle initial)

Title of Company Officer:

Company Organizational
Structure:

Officer's Date of Birth:

Account's Business Activity with CBP/Identifying Information
If more than one activity is noted, please choose the primary activity by selecting the "Primary Activity" box. For all other activities, choose "Other." Depending
on the account type being established, the following identifying information is required to set up an ACE portal account. You are limited to a single
identification number for the portal account being requested with the exception of: Importer, broker, filer, software vendor, service bureau, port authority,
preparer or surety agent which can use up to three identifying numbers for each portal view.

1. Importer/Broker/Filer/Surety:
If you are requesting to participate as a Third Party Manifest Submitter, please check "Carrier" as your primary activity. For additional information regarding how
to obtain a Manifest Preparer Code, please contact Daniel Buchanan at [email protected].

Primary or Other view - Select only ONE Primary View
a. Importer

P

O

NA

IR#:

b. Broker

P

O

NA

Filer Code:

c. Self Filer

P

O

NA

Filer Code:

d. Surety

IR#:

Note: If you are applying for a new account type you must first have the CBP Revenue Division create your profile in ACE. Please also indicate
the date you submitted that request to the CBP Revenue Division and provide your Surety Code and EIN/SSN in the blocks below. If you are
applying for an account that is already established with CBP, please submit your Surety Code and EIN/SSN only.

P

O

NA

EIN/SSN:

Surety
Code:

Surety
Code:

Date submitted to
CBP, Revenue Division:

Before submitting, please ensure that the form is signed on the last page

Surety
Code:

2. Service Provider (indicate type):

a. Software Vendor

Primary/Other - Select only ONE Primary View
SCAC or
P
O
NA
Filer Code:

EIN/SSN:

b. Service Bureau/Ctr.

P

O

NA

SCAC or
Filer Code:

EIN/SSN:

c. Port Authority

P

O

NA

SCAC:

EIN/SSN:

d. Preparer

P

O

NA

SCAC:

EIN/SSN:

e. Surety Agent

P

O

NA

EIN/SSN:

Filer
Code:

3. Facility Operator/Foreign Trade Zone Operator/Cartman/Lighterman
NOTE: The “Name of Company” (see Section A. Account Information) must match the name on your bond.
Please provide: your EIN/SSN, bond number and FIRMS code. If you have facilities in multiple ports, list up to three FIRMS codes:

a. Facility Operator

FIRMS Codes:

Primary/Other

(e.g., Warehouse, Container
Freight Station, Container
Examination Station)

P

O

NA

EIN/SSN:

Bond Number:
(Required)

Note: If you used an SSN, you must complete the following two questions:

Has your background investigation
with CBP been completed?
b. Foreign Trade Zone

Y

Are your fingerprints on file with CBP?

N

Y

N

Please provide your EIN/SSN, bond number, FIRMS code, Zone Number, Sub-zone Numbers and Site Number:
Primary/Other

P

O

NA

FIRMS Code:

EIN/SSN:

Bond Number:
(Required)

Zone
Number:

Sub-Zone
Numbers:

Site
Number:

Note: If you used an SSN, you must complete the following two questions:

Has your background investigation
with CBP been completed?
c. Cartman

Y

N

Y

Are your fingerprints on file with CBP?

N

Primary/Other

P

O
Driver's
License #

Cartman Travel Documentation

NA

Cartman ID#:

Customhouse
License (CHL)#:

Status:

State/
Province:

Country:

(Enter as appropriate, one set of documentation is required.)

Passport #

Country:

Date of
Expiration:

US Visa #

Birth Certificate

Permanent
Resident Card #:

Certificate of
Naturalization:

Certificate of US
Citizenship:

Re-entry
Permit #:
(I-327)

Refugee
Permit#:

Other ID:

Are your fingerprints
on file with CBP?

Before submitting, please ensure that the form is signed on the last page

Y

N

d. Lighterman

Primary/Other

P

NA

O

Lighterman ID#:

Customhouse
License (CHL)#:

Status:
State/
Province:

License #

Country:

Lighterman Travel Documentation (Enter as appropriate, one set of documentation is required.)
Date of
Expiration:

Country:

Passport #

Permanent
Resident Card #:

Birth Certificate

US Visa #
Certificate of
Naturalization:

Re-entry
Permit #:
(I-327)

Certificate of US
Citizenship:

Refugee
Permit#:

Are your fingerprints
on file with CBP?

Other ID:

Y

4. Air Carrier/Rail Carrier/Sea Carrier/Truck Carrier/Driver/Crew:
a. Air Carrier

Primary/Other

O

P

b. Rail Carrier

ICAO Codes (3 Char)

NA

IATA Codes (2 Char)

Primary/Other

P

c. Sea Carrier

O

SCAC

NA

Active Type 2 Bond Number

Primary/Other

P

d. Truck Carrier

O

SCAC

NA

Active Type 2 Bond Number

Primary/Other

P
e. Driver/Crew (nonFAST drivers only)

O
P

SCAC

NA
O

NA

State/
Province:

CDL #:

Enhanced CDL?

This section is NOT required for a
CARRIER view; only for a Driver/Crew view

Yes

No

Country:

Haz-Mat Endorsement?

Yes

No

Date of
Birth:

Complete
Name w/MI

Gender:

Citzenship/
Nationality:

Travel Documentation (enter as appropriate; one set is required if Enhanced CDL is not used):
Passport #:

Country:

Permanent Residence Card:

Country of Issuance:

Other Doc Type:

Before submitting, please ensure that the form is signed on the last page

Male

Female

N

Section B. Account Owner Designation
This is the individual responsible for the daily administration of the Account's activities. Please complete either Part 1 or 2 of this
section. If the Account Owner is an individual, please ONLY fill out Part 1. If the Account Owner is a legal entity, please fill out
ONLY Part 2 and complete Section C.

Part 1. Individual
If the Accout Owner is an individual (that is not a corporation, partnership, etc.) please provide the following information:
Prefix/Title:

Application Date for
an ACE Portal Account

Name (include middle initial):

Business E-mail Address:

Date of Birth:
NOTE: An Account Owner for a U.S. based truck carrier or truck driver must supply a U.S. business address. A foreign-based truck carrier or truck driver must provide
their foreign business address and is not required to provide a U.S. business address. If applying for a Broker, Importer or Filer Account, a U.S. address is required.
Importers who are self filers should apply for both their importer and their filer view on one ACE application.
Account Owner's Complete Business Address:
Country:

Street Address (P.O. Boxes not allowed):

State/Province:

City:

Zip/Postal Code:

Business Telephone Number:

Part 2. Legal Entity
If the Account Owner is a legal entity (that is, corporation, partnership, etc. ), not an individual, as identified above, please provide the following information. If
you complete this section, you must complete Part C, "Point of Contact " below.
Application Date for
an ACE Portal Account

Name :

NOTE: An Account Owner for a U.S. based truck carrier or truck driver must supply a U.S. business address. A foreign-based truck carrier or truck driver must provide
their foreign business address and is not required to provide a U.S. business address. If applying for a Broker, Importer or Filer Account, a U.S. address is required.
Importers who are self filers should apply for both their importer and their filer view on one ACE application.
Account Owner's Complete Business Address:
Country:

City:

Street Address (P.O. Boxes not allowed):

State/Province:

Zip/Postal Code:

Before submitting, please ensure that the form is signed on the last page

Business Telephone Number:

Section C. Point of Contact for the Account
Point of Contact
Prefix/Title:

Name (include middle initial):

Date of Birth:
Point of Contact's Complete Business Address:
Country:

Business E-mail Address:

NOTE: An Account Owner for a U.S. based truck carrier or truck driver must supply a U.S. business address. A
foreign-based truck carrier or truck driver must provide their foreign business address and is not required to
provide a U.S. business address. If applying for a Broker, Importer or Filer Account, a U.S. address is required.

Street Address (PO Boxes not allowed):

City:

State/Province:

Zip/Postal Code:

Business Telephone Number:

Section D. Authorization and Acknowledgement
The account owner AND company officer must sign below to indicate authorization/approval of the information contained in this
document. A false statement or claim may subject a person to prosecution under 18 U.S.C. 1001 and/or 1621 and is punishable
by a fine and up to five years imprisonment. You must click on BOTH electronic signature boxes to indicate authorization/approval
of the information contained in this document. To select a box, click in the box to the left of the statement. This will act as your
electronic signature. A false statement or claim may subject a person to prosecution under 18 U.S.C. 1001 and/or 1621 and is
punishable by a fine and up to five years imprisonment.
Name of Company Officer:

Company Officer

Date

Date

By selecting this box I am verifying that I am legally authorized to bind my company to the ACE
Secure Data Portal and its terms and conditions. (electronic signature)
Name of Account Owner or Account Owner's Point of Contact:
Account Owner or Account Owner's Point of Contact

Date

By selecting this box I am verifying that I am legally authorized to bind my company to the ACE
Secure Data Portal and its terms and conditions. (electronic signature)

Date

If submitting this form via mail, please provide the required original signatures at the end of this application and send the completed document to:
ACE Secure Data Portal - ACE Application
U.S. Customs and Border Protection
7681 Boston Blvd.
Attn: Beauregard Building, Room A 311-4
Springfield, VA 22153

Thank you! U.S. Customs and Border Protection looks forward to working with you!

Submitsubmitting,
by E-mail please ensure
Reset
Form
Form
Before
that
the form is signedPrint
on the
last page