Form CBP Form 3485 CBP Form 3485 Lien Notice

DEPARTMENT OF HOMELAND SECURITY

OMB CONTROL NUMBER: 1651-0012
EXPIRATION DATE: 07/31/2025

U.S. Customs and Border Protection
LIEN NOTICE

19 U.S.C. 66, 1564; 19 CFR 141.112
PORT:

CBP ASSIGNED NO.:

NAME OF CONSIGNEE/IMPORTER:

DATE OF NOTICE:
NAME OF CARRIER:

DATE OF ARRIVAL:
B/L NO. OR CBP 7512 NO.:

LOCATION OF GOODS:

MARKS AND NUMBERS

NO. OF PACKAGES

A. FREIGHT:

REMARKS

B. CHARGES:

AMOUNTS CLAIMED

C. CONTRIBUTIONS TO
GENERAL AVERAGE:

D. TOTAL:

0

STATEMENT OF AGENT: I, the Undersigned, agent of the above-named carrier, certify that the carrier has a lien on the above-listed merchandise in
accordance with Sections 564 and 613 of the Tariff Act of 1930. I further certify that the information set forth in this notice is true to the best of my knowledge
and belief, and that the sum claimed is due and unpaid and was a subsisting lien upon the goods described at the time they passed into U.S. Customs and
Border Protection (CBP) custody. I understand that sale of this merchandise by the Government for any reason does not entitle claimants to advance notice in
the absence of a written request identifying the goods with this notice. I also agree upon the discharge or satisfaction of this lien, to promptly notify the CBP
office at the above-named port by filing a written release or receipt showing payment of the claim in full.
SIGNATURE OF AGENT:

LIENHOLDER
NAME:
SIGNATURE OF LIENHOLDER:

DATE:

ADDRESS:
TITLE:

STATEMENT OF CLAIMANT: The amounts claimed as due and unpaid have been satisfied.
SIGNATURE OF CLAIMANT:

DATE:

DATE:

DISPOSITION (CBP USE ONLY)
CBP OFFICER
NAME:
SIGNATURE OF CBP OFFICER:

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 1651-0012. The estimated
average time to complete this application is 15 minutes. Obligation to respond is required to obtain benefits. 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, D.C., 20002.
CBP Form 3485 (01/25)

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