CBP Form 214 Application for FTZ Admission and/or Status Designation

OMB APPROVAL NO.1651-0029
EXPIRATION DATE 2/28/2022

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection

APPLICATION FOR FOREIGN-TRADE ZONE ADMISSION AND/OR STATUS DESIGNATION
19 CFR 146.22, 146.32, 146.35-146.37, 146.39-146.41, 146.44, 146.53, 146.66

CITY:

CENSUS USE ONLY

2. ZONE NO.

1. ZONE LOCATION (Address)
ADDRESS:
STATE:

3. PORT CODE

ZIP CODE:

4. IMPORTING VESSEL (& FLAG)/OTHER CARRIER

5. EXPORT DATE

6. IMPORT DATE

7. ZONE ADMISSION NO.

8. U.S. PORT OF UNLADING

9. FOREIGN PORT OF LADING

10. BILL OF LADING/AWB NO. 11. INWARD M'FEST NO.

12. INBOND CARRIER

13. I.T. NO. AND DATE

14. I.T. FROM (Port)

15. STATISTICAL INFORMATION FURNISHED DIRECTLY TO BUREAU OF CENSUS BY APPLICANT?
16.
NO. OF PACKAGES
AND COUNTRY
OF ORIGIN CODE

17.
DESCRIPTION OF MERCHANDISE

YES
19.
QUANTITY
(HTSUS)

18.
HTSUS NO.

NO
20.
GROSS
WEIGHT

21.
SEPARATE
VALUE & AGGR
CHGS.

22. HARBOR MAINTENANCE FEE (19 CFR 24.24)
23. I hereby apply for admission of the above merchandise into the Foreign-Trade Zone. I declare to the best of my knowledge and belief that the above
merchandise is not prohibited entry in the Foreign-Trade Zone within the meaning of section 3 of the Foreign-Trade Zones Act of 1934, as amended,
and section 146.31, Customs Regulations.
24. I hereby apply for the status designation indicated:
NONPRIVILEGED FOREIGN
PRIVILEGED FOREIGN
(19 CFR 146.42)
(19 CFR 146.41)
25. APPLICANT FIRM NAME
26. BY (Signature)

F.T.Z. AGREES TO RECEIVE
MERCHANDISE INTO THE ZONE
PERMIT

Permission is hereby granted to
transfer the above merchandise
into the Zone.

PERMIT

The above merchandise has been
granted the requested status.

ZONE RESTRICTED
(19 CFR 146.44)
27. TITLE

FTZ
OPERATOR'S
REPORT OF
MERCHANDISE
RECEIVED AT
ZONE

28. DATE

29. FOR THE F.T.Z. OPERATOR (Signature)

30. TITLE

31. DATE

32. PORT DIRECTOR OF CBP: BY (Signature)

33. TITLE

34. DATE

35. PORT DIRECTOR OF CBP: BY (Signature)

36. TITLE

37. DATE

38. The goods described herein are authorized to be transferred:

PERMIT
TO
TRANSFER

DOMESTIC
(19 CFR 146.43)

without exception

except as noted below

39. CBP OFFICER AT STATION (Signature)

40. TITLE

41. STATION

42. DATE

43. RECEIVED FOR TRANSFER TO ZONE (Driver's Signature)

44. CARTMAN

45. CHL NO.

46. DATE

47. To the Port Director of CBP: The above merchandise was received at the Zone on the date shown except as noted below:

48. FOR THE FTZ OPERATOR (Signature)

49. TITLE

50. DATE

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 1651-0029.
The estimated average time to complete this application is 15 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, 90 K Street NE, Washington, DC 20229

CBP Form 214 (7/21)