Form 3461ALT Entry and Immediate Delivery

Entry/Immediate Delivery Application and Simplified Entry

CBP Form 3461Alt Sample

Enty/Immediate Delivey Alternate

OMB: 1651-0024

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19 CFR 142.3, 142.16, 142.22, 142.24

C00-0000000-7
1. Ultimate Consignee No.

2. Importer No.

3. HTSUS NO.

4. Ctry. Orig.

6. No. Inv. Pgs.

DEPARTMENT OF HOMELAND SECURITY

OMB No.

U.S. Customs and Border Protection

1651-0024

C00-0000000-7
1. Ultimate Consignee No.

8. Station

2. Importer No.

9. No. of Pkgs.

5. Manufacturer ID

7. Total Invoice Value

I hereby make application for entry/immediate delivery. I
certify that the information provided is accurate, the bond is
sufficient, valid, and current, and that all requirements of 19
CFR Part 142 have been met.
Signature of Applicant
Date

CBP Form 3461 ALT (10/11)

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 16510024. The estimated average time to complete this application is 3 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.

ENTRY/IMMEDIATE DELIVERY


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AuthorCHDBRT9
File Modified2014-01-14
File Created2014-01-14

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