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

OMB CONTROL NUMBER: 1651-0029
EXPIRATION DATE: 01/31/2026

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection
APPLICATION FOR
FOREIGN-TRADE ZONE ADMISSION
AND/OR STATUS DESIGNATION

CENSUS USE ONLY

ZONE NO. AND LOCATION (Address)

19 CFR 146.32, 146.40

IMPORTING VESSEL (& FLAG)/OTHER CARRIER

PORT CODE

IMPORT DATE

EXPORT DATE

ZONE ADMISSION NO.

U.S. PORT OF UNLADING

FOREIGN PORT OF LADING

BILL OF LADING/AWB NO.

INBOND CARRIER

I.T. NO. AND DATE

I.T. FROM (Port)

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

.
HTSUS NO.

DESCRIPTION OF MERCHANDISE

YES
.
QUANTITY
(HTSUS)

INWARD M'FEST NO.

NO
.
GROSS
WEIGHT

SEPARATE
VALUE & AGGR
CHGS.

HARBOR MAINTENANCE FEE (19 CFR 24.24)
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.
I hereby apply for the status designation indicated:
ZONE RESTRICTED
PRIVILEGED FOREIGN
DOMESTIC
NONPRIVILEGED FOREIGN
(19 CFR 146.44)
(19 CFR 146.41)
(19 CFR 146.43)
(19 CFR 146.42)
BY (Signature)
DATE
APPLICANT FIRM NAME
TITLE

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

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

Permission is hereby granted to PORT DIRECTOR OF CBP: BY (Signature)
transfer the above merchandise
into the Zone.
The above merchandise has been PORT DIRECTOR OF CBP: BY (Signature)
granted the requested status.
The goods described herein are authorized to be transferred:

PERMIT
TO
TRANSFER

CBP OFFICER AT STATION (Signature)
RECEIVED FOR TRANSFER TO ZONE (Driver's Signature)

TITLE

DATE

TITLE

DATE

TITLE

DATE

without exception

except as noted below

TITLE

STATION

DATE

CARTMAN

CHL NO.

DATE

To the Port Director of CBP: The above merchandise was received at the Zone on the date shown except as noted below:
FTZ
OPERATOR'S
REPORT OF
MERCHANDISE
RECEIVED AT
DATE
TITLE
FOR THE FTZ OPERATOR (Signature)
ZONE
CBP Form 214A (4/24)

STATISTICAL COPY

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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 20002.

CBP Form 214A (4/24)

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