Form CBP Form 3173 CBP Form 3173 Application for Extension of Bond for Temporary Importat

DEPARTMENT OF HOMELAND SECURITY

OMB APPROVAL NO. 1651-0015
EXPIRES: 04/30/2022

U.S. Customs and Border Protection

APPLICATION FOR EXTENSION OF BOND FOR TEMPORARY IMPORTATION
19 U.S.C. 66, 1202; 19 CFR 10.37
(Chap. 98, Subchapter XIII, Harmonized Tariff Schedules of the United States)

1. NAME OF IMPORTER (Last, First, MI)

2. TIB ENTRY NUMBER

3. DATE OF THIS REQUEST

5. TARIFF ITEM NUMBER

6. DATE OF IMPORTATION

7. NUMBER AND DURATION OF
PREVIOUS EXTENSIONS

8. DATE TO WHICH THIS
EXTENSION IS REQUESTED

ADDRESS OF IMPORTER
LINE 1
LINE 2
CITY
STATE
4. DESCRIPTION OF MERCHANDISE

ZIP

(NOT TO EXCEED 3 YEARS
FROM DATE OF IMPORTATION)

9. REASON FOR APPLICATION (State why goods have not been exported or destroyed within the original bond period of authorized extension.)

10. DESCRIBE BRIEFLY ALL USES TO WHICH THE ARTICLES HAVE BEEN PUT SINCE IMPORTATION

11. DESCRIBE BRIEFLY ALL USES TO WHICH THE ARTICLES WILL BE PUT DURING THE PERIOD OF EXTENSION

12. HAVE THE ARTICLES BEEN OFFERED FOR SALE OR SALE ON APPROVAL

THIS BLOCK FOR CBP USE ONLY

YES (Give details below)

NO

13. I DECLARE THAT ALL THE FACTS STATED ABOVE ARE TRUE AND
ACCURATE IN ALL RESPECTS.

DATE
APPLICATION
APPROVED

PORT DIRECTOR
BY:

(SIGNATURE)
(TITLE)

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 1651-0015. The estimated average time to complete this application is 13 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 3173 (7/21)

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PRIVACY ACT STATEMENT
Application for Extension of Bond for Temporary Importation:
Pursuant to 5 U.S.C. § 552a (e)(3), this Privacy Act Statement serves to inform you of why DHS is requesting the information on this form.
Authority:
U.S. Customs and Border Protection (CBP) is authorized to collect the information requested on this form pursuant to 19 U.S.C. 66, 1202, 19
CFR 10.31-10.40, 19 CFR 10.37 19, and CFR 10.31.
Purpose:
CBP is collecting this information to be used for Extension of Bond for Temporary Importation, when imported merchandise enters the United
States as a temporary importation for a period of one year or less without the payment of duties and the temporary period granted is not
sufficient.
Routine Uses:
The information requested in this form may be shared externally as a “routine uses” to other government agencies if your inquiry relates to those
agencies, or to assist the Department of Homeland Security in reviewing the activity subject to protest. A complete lists of routine uses can be
found in the system of records notice associated with this form, “Department of Homeland Security/CBP-001 - Import Information System.” The
Department’s full list of system of records notices can be found on the Department's website at http://www.dhs.gov/system-records-notices-sorns
Consequences of Failure to Provide Information:
Providing this information is voluntary. However, without this information CBP would be unable to determine whether to grant a temporary
extension.

CBP Form 3173 (7/21)

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