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Continued Dumping and Subsidy Offset Act of 2000 Certification
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Contact: CDSOA/Byrd Help
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You have accessed a United States Government computer. Unauthorized use of this computer is a violation of federal law and may subject you to civil and criminal penalties. This computer
and the automated systems which run on it are monitored. Individuals are not guaranteed privacy while using government computers and should, therefore, not expect it. Communications
made using this system may be disclosed as allowed by federal law.
Note: This system may contain Sensitive But Unclassified (SBU) data that requires specific data privacy handling.
Contact Us | Notices & Agreements | Accessibility Policy | Privacy & Security Policy | For Agencies |
https://www.pay.gov/public/form/start/8776895/
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12/27/2016
Pay.gov - Continued Dumping and Subsidy Offset Act of 2000 Certification
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Continued Dumping and Subsidy Offset Act of 2000 Certification
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1 Complete Agency Form
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Department of Homeland Security
U.S. Customs and Border Protection
Continued Dumping and Subsidy Offset Act of 2000 Form
OMB No. 1651-0086
Exp. 12-31-2016
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lead to incomplete data being transmitted and pages being loaded incorrectly.
Claimant's Information
1. Claimant's Name:
(As it appears on USITC List or Association Membership List, if applicable)
(If person's name, list Last Name, First Name)
2. Mailing Address:
3. Address 2:
4. City:
5. State:
6. ZIP/Postal Code:
Check here if Mailing Address is a PO Box.
(Street Address is required when Mailing Address is a PO Box)
7. Street Address:
8. Address 2:
9. City:
10. State:
11. ZIP/Postal Code:
12. Business Type (select one):
Sole Proprietorship
Partnership
Corporation
13. Number Type (select one and enter number below):
Social Security Number
Employee Identification Number
Federal Tax Identification Number
Enter Number Here
Contact Information (Primary Contact For All Certification Related Inquiries)
14. Contact Person:
15. Contact Email:
16. Contact Phone:
17. Contact Fax:
(If Different From Claimant's Mailing Address)
18. Address:
19. Address 2:
20. City:
21. State:
22. ZIP/Postal Code:
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CBP Form 7401 (12/16)
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WARNING WARNING WARNING
You have accessed a United States Government computer. Unauthorized use of this computer is a violation of federal law and may subject you to civil and criminal penalties. This computer
and the automated systems which run on it are monitored. Individuals are not guaranteed privacy while using government computers and should, therefore, not expect it. Communications
made using this system may be disclosed as allowed by federal law.
Note: This system may contain Sensitive But Unclassified (SBU) data that requires specific data privacy handling.
Contact Us | Notices & Agreements | Accessibility Policy | Privacy & Security Policy | For Agencies |
https://www.pay.gov/public/form/entry/101/
*
12/27/2016
File Type | application/pdf |
File Title | https://www.pay.gov/public/form/entry/101/ |
Author | BCHCTJ1 |
File Modified | 2016-12-27 |
File Created | 2016-12-27 |