Agriculture Wool Apparel Manufacturers Trust Fund

APPLICATION FOR 2016 PAYMENTS

WOOL YARN, WOOL FIBER, OR WOOL TOP DUTY COMPENSATION

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015 

Please check if processing of wool fiber, wool top, or yarn spinning occurs in your own plants.

and/or

Please check if processing of wool fiber, wool top, or yarn spinning occurs by a contractor and you had title to the fabric.

Note: Data based on microns.

Signature of Representative

Date

Signature of Notary

Date

Certification Statement: I, the duly authorized representative, as an employee, officer or agent, with personal knowledge of the matters set out in the application, certify that the information contained herein is complete and accurate, signed and sworn before a Notary Public, and acknowledging that false representations to a federal agency may result in criminal penalties under federal law.

If data provided is to be treated as Business Confidential, please indicate prominently across top of form.

Data for January-December 2015

AVERAGE FIBER DIAMETER 18.5 MICRONS OR LESS

Company Name:	_______________________	Contact Name:	______________________ 
Company Address:	_______________________ 	Contact Address:	______________________ 
	_______________________ 		______________________ 
	_______________________ 		______________________ 
Company Federal Tax		Contact Telephone Number:		________________ 
Identification Number:	_______________________ 	Contact Email Address:		________________ 

Instructions: Please provide production (actual not estimated) data as requested for the applicable HTS headings under Part A (HTS 9902.51.13) and Part B (HTS 9902.51.14) of this affidavit. Persons submitting an affidavit only need to submit the relevant pages. If additional space for listing plants and/or contractors is needed, reuse the appropriate page(s) from Part A and/or B again after printing.

PART A. This form is for persons who are reporting production data for HTS 9902.51.13 “Yarn of combed wool, not put up for retail sale, containing 85 percent or more by weight of wool, formed with wool fibers having diameters of 18.5 microns or less.” Subheading 5107.10.30 is included.

PART B. These forms are for persons who are reporting imports for HTS 9902.51.14 “Wool fiber, waste, garnetted stock, combed wool, or wool top, having average fiber diameters of 18.5 microns or less.” Subheadings 5101.11.60, 5101.19.60, 5104.00.00*, 5101.21.40, 5101.21.70, 5101.29.40, 5101.29.70, 5101.30.70, 5101.30.40, 5103.10.00, 5103.20.00, 5105.21.00 and 5105.29.00 are included.

Public reporting for this collection of information is estimated to average 3 hours per response, including the time for reviewing instructions, and completing and reviewing the collection of information. All responses to this collection of information are voluntary, and will be provided confidentiality to the extent allowed under the Freedom of Information Act. Notwithstanding any other provision of the 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 the 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 Import Policies and Export Reporting Division at: [email protected]

*Note: Imported wool under Subheading 5104.00.00 is duty free and therefore not eligible for compensation.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015

PART A (Subheading 5107.10.30)

HTS 5107.10.30 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Colombia (CO), Israel (IL), Jordan (JO), South Korea (KR), Morocco (MA), Mexico (MX), CAFTA-DR/1 (P), Panama (PA), Peru (PE), and Singapore (SG). Imports from these countries under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
Quantity and Value	Clean kg	($)
Production (fob plant)
Names and Addresses of Plants Processing Wool Yarn of the Kind Described in 9902.51.13 in the Preceding Calendar Year.	1)
	2)
	3)
	4)
	5)
	6)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic.

HTS 5107.10.30
	Yarn of combed wool, not put up for retail sale, containing 85 percent or more by weight of wool, formed with wool fibers having diameters of 18.5 microns or less.
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015

PART B (Subheading 5101.11.60)

HTS 5101.11.60 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Colombia (CO), CBERA/1 (E), Israel (IL), Jordan (JO), South Korea (KR), Morocco (MA), Mexico (MX), Oman (OM), CAFTA-DR/2 (P), Panama (PA), Peru (PE), and Singapore (SG). Imports from these countries under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
Quantity and Value	Clean kg	($)
Production (fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in the Preceding Calendar Year.	1)
	2)
	3)
	4)
	5)
	6)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic. /2 CBERA countries: Antigua Barbuda; Aruba; Bahamas; Barbados; Belize; Br Virgin Islands; Curacao; Dominica Island; Grenada Island; Guyana; Haiti; Jamaica; Monserrat Island; Netherlands Antilles; St. Kitts and Nevis; St. Lucia Island; St. Vincent and Grenada; Trinity and Tobago.

HTS 5101.11.60
	Wool, excluding unimproved, finer than 46s, greasy, shorn, not carded or combed. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015

PART B (Subheading 5101.19.60)

HTS 5101.19.60 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Colombia (CO), CBERA/1 (E), Israel (IL), Jordan (JO), Mexico (MX), Oman (OM), CAFTA-DR/2 (P), Panama (PA), Peru (PE), and Singapore (SG). Imports from these countries under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
Quantity and Value	Clean kg	($)
Production (fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in the Preceding Calendar Year.	1)
	2)
	3)
	4)
	5)
	6)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic. /2 CBERA countries: Antigua Barbuda; Aruba; Bahamas; Barbados; Belize; Br Virgin Islands; Curacao; Dominica Island; Grenada Island; Guyana; Haiti; Jamaica; Monserrat Island; Netherlands Antilles; St. Kitts and Nevis; St. Lucia Island; St. Vincent and Grenada; Trinity and Tobago.

HTS 5101.19.60
	Wool, excluding unimproved, finer than 46s, greasy, incl. fleece-washed, not shorn, not carded or combed. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015

PART B (Subheading 5101.21.40)

HTS 5101.21.40 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Colombia (CO), CBERA/1 (E), Israel (IL), Jordan (JO), South Korea (KR), Morocco (MA), Mexico (MX), Oman (OM), CAFTA-DR/2 (P), Panama (PA), Peru (PE), and Singapore (SG). Imports from these countries under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
	Quantity and Value (Production fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in preceding calendar year.	Clean kg	($)
1)
2)
3)
4)
5)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic. /2 CBERA countries: Antigua Barbuda; Aruba; Bahamas; Barbados; Belize; Br Virgin Islands; Curacao; Dominica Island; Grenada Island; Guyana; Haiti; Jamaica; Monserrat Island; Netherlands Antilles; St. Kitts and Nevis; St. Lucia Island; St. Vincent and Grenada; Trinity and Tobago.

HTS 5101.21.40
	Wool, excl. unimproved, finer than 46s, degreased, not further processed, shorn, not carded or combed, not for special uses. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015

PART B (Subheading 5101.21.70)

HTS 5101.21.70 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Israel (IL), Jordan (JO), Morocco (MA), Mexico (MX), Oman (OM), CAFTA-DR/1 (P), Peru (PE), and Singapore (SG). Imports from these countries under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
	Quantity and Value (Production fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in preceding calendar year.	Clean kg	($)
1)
2)
3)
4)
5)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic.

HTS 5101.21.70
	Unimproved wool and other wool, finer than 46s, degreased, shorn, not carbonized, not carded or combed. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015

PART B (Subheading 5101.29.40)

HTS 5101.29.40 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Colombia (CO), CBERA/1 (E), Israel (IL), Jordan (JO), South Korea (KR), Morocco (MA), Mexico (MX), Oman (OM), CAFTA-DR/2 (P), Panama (PA), Peru (PE), and Singapore (SG). Imports from these countries under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
	Quantity and Value (Production fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in preceding calendar year.	Clean kg	($)
1)
2)
3)
4)
5)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic. /2 CBERA countries: Antigua Barbuda; Aruba; Bahamas; Barbados; Belize; Br Virgin Islands; Curacao; Dominica Island; Grenada Island; Guyana; Haiti; Jamaica; Monserrat Island; Netherlands Antilles; St. Kitts and Nevis; St. Lucia Island; St. Vincent and Grenada; Trinity and Tobago.

HTS 5101.29.40
	Wool, excl. unimproved, finer than 46s, degreased, not further processed, not shorn, not carded or combed, not for special uses. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015 PART B (Subheading 5101.29.70)

HTS 5101.29.70 NOTE – Do not report imported wool under this subheading from the following countries: Bahrain (BH), Canada (CA), Chile (CL), Israel (IL), Jordan (JO), Morocco (MA), Mexico (MX), Oman (OM), and Singapore (SG). Imports from these countries under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
	Quantity and Value (Production fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in preceding calendar year.	Clean kg	($)
1)
2)
3)
4)
5)

HTS 5101.29.70
	Wool, finer than 46s, not carded or combed, not carbonized, not shorn, degreased and processed to remove grease. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015 PART B (Subheading 5101.30.70)

HTS 5101.30.70 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Israel (IL), Jordan (JO), Morocco (MA), Mexico (MX), Oman (OM), Peru (PE), and Singapore (SG). Imports under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
	Quantity and Value (Production fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in preceding calendar year.	Clean kg	($)
1)
2)
3)
4)
5)

HTS 5101.30.70
	Unimproved wool and other wool, finer than 46s, carbonized and further processed, not carded or combed. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015 PART B (Subheading 5101.30.40)

HTS 5101.30.40 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Colombia (CO), CBERA/1 (E), Israel (IL), Jordan (JO), South Korea (KR), Morocco (MA), Mexico (MX), Oman (OM), CAFTA-DR/2 (P), Panama (PA), Peru (PE), and Singapore (SG). Imports under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
	Quantity and Value (Production fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in preceding calendar year.	Clean kg	($)
1)
2)
3)
4)
5)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic. /2 CBERA countries: Antigua Barbuda; Aruba; Bahamas; Barbados; Belize; Br Virgin Islands; Curacao; Dominica Island; Grenada Island; Guyana; Haiti; Jamaica; Monserrat Island; Netherlands Antilles; St. Kitts and Nevis; St. Lucia Island; St. Vincent and Grenada; Trinity and Tobago.

HTS 5101.30.40
	Wool, excluding unimproved, finer than 46s, carbonized, not further processed, not carded or combed. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015 PART B (Subheading 5103.10.00)

HTS 5103.10.00 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Colombia (CO), CBERA/1 (E), Israel (IL), Jordan (JO), South Korea (KR), Morocco (MA), Mexico (MX), Oman (OM), CAFTA-DR/2 (P), Panama (PA), Peru (PE), and Singapore (SG). Imports under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
	Quantity and Value (Production fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in preceding calendar year.	Clean kg	($)
1)
2)
3)
4)
5)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic. /2 CBERA countries: Antigua Barbuda; Aruba; Bahamas; Barbados; Belize; Br Virgin Islands; Curacao; Dominica Island; Grenada Island; Guyana; Haiti; Jamaica; Monserrat Island; Netherlands Antilles; St. Kitts and Nevis; St. Lucia Island; St. Vincent and Grenada; Trinity and Tobago.

HTS 5103.10.00
	Noils of wool or of fine animal hair. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015 PART B (Subheading 5103.20.00)

HTS 5103.20.00 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Colombia (CO), CBERA/1 (E), Israel (IL), Jordan (JO), South Korea (KR), Morocco (MA), Mexico (MX), CAFTA-DR/2 (P), Panama (PA), Peru (PE), and Singapore (SG). Imports under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
	Quantity and Value (Production fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in preceding calendar year.	Clean kg	($)
1)
2)
3)
4)
5)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic. /2 CBERA countries: Antigua Barbuda; Aruba; Bahamas; Barbados; Belize; Br Virgin Islands; Curacao; Dominica Island; Grenada Island; Guyana; Haiti; Jamaica; Monserrat Island; Netherlands Antilles; St. Kitts and Nevis; St. Lucia Island; St. Vincent and Grenada; Trinity and Tobago.

HTS 5103.20.00
	Waste, other than noils, of wool or of fine animal hair, including yarn waste but excluding garnetted stock. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015

PART B (Subheading 5105.21.00)

HTS 5105.21.00 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Colombia (CO), Israel (IL), Jordan (JO), South Korea (KR), Morocco (MA), Mexico (MX), CAFTA-DR/1 (P), Panama (PA), Peru (PE), and Singapore (SG). Imports under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
	Quantity and Value (Production fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in preceding calendar year.	Clean kg	($)
1)
2)
3)
4)
5)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic.

HTS 5105.21.00
	Combed wool in fragments. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.

For 9902.51.13 & For 9902.51.14 OMB No.: 0551-0045 Expires 09/30/2015

PART B (Subheading 5105.29.00)

HTS 5105.29.00 NOTE – Do not report imported wool under this subheading from the following countries: Australia (AU), Bahrain (BH), Canada (CA), Chile (CL), Colombia (CO), Israel (IL), Jordan (JO), South Korea (KR), Morocco (MA), Mexico (MX), CAFTA-DR/1 (P), Panama (PA), Peru (PE), and Singapore (SG). Imports under this subheading are duty free and therefore not eligible for compensation.
Period	January-December 2015
	Quantity and Value (Production fob plant)
Names and Addresses of Plants Processing Wool Fiber/Top of the Kind Described in HTS 9902.51.14 in preceding calendar year.	Clean kg	($)
1)
2)
3)
4)
5)

/1 CAFTA-DR countries: Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua, and the Dominican Republic

HTS 5105.29.00
	Wool tops and other combed wool, except in fragments. (Note: Report only imported wool fibers having diameters of 18.5 microns or less)
	January-December 2015
	Quantity and Value (Value = Customs Entered Value*)
Country Imported From	Clean kg	($)
1)
2)
3)
4)
5)
6)
7)
8)

*Nondirect importers enter the value that the material was purchased.