CBP New Security Filing Date Requirements 10+2


Vessel Name & Voyage #:
ETD:
ETA:
AMS HBL# & SCAC:
MBL# & SCAC:


1. Importer of Record

2. Buyer

Name: Name:
Address 1: Address 1:
Address 2: Address 2:
City: City:
State: State:
Postal Code: Postal Code:
Country: Country:
Tel: Tel:
IRS #: IRS #:


3. Ship To

4. Manufacturer / Supplier

Name: Name:
Address 1: Address 1:
Address 2: Address 2:
City: City:
State: State:
Postal Code: Postal Code:
Country: Country:
Tel: Tel:
IRS #:  


5. Seller

6. Consolidator

Name: Name:
Address 1: Address 1:
Address 2: Address 2:
City: City:
State: State:
Postal Code: Postal Code:
Country: Country:
Tel: Tel:


7. Container Stuffing Location

8. Consignee

Name: Name:
Address 1: Address 1:
Address 2: Address 2:
City: City:
State: State:
Postal Code: Postal Code:
Country: Country:
Tel: Tel:
IRS #:




9. - 10. Details

Part Number: Part Number:
Country of Origin: Country of Origin:
Commodity Code (HTS): Commodity Code (HTS):


Part Number: Part Number:
Country of Origin: Country of Origin:
Commodity Code (HTS): Commodity Code (HTS):


Part Number: Part Number:
Country of Origin: Country of Origin:
Commodity Code (HTS): Commodity Code (HTS):


Part Number: Part Number:
Country of Origin: Country of Origin:
Commodity Code (HTS): Commodity Code (HTS):


Part Number: Part Number:
Country of Origin: Country of Origin:
Commodity Code (HTS): Commodity Code (HTS):


Part Number: Part Number:
Country of Origin: Country of Origin:
Commodity Code (HTS): Commodity Code (HTS):


Part Number: Part Number:
Country of Origin: Country of Origin:
Commodity Code (HTS): Commodity Code (HTS):


Notations



Name of Individual Providing Information:
Date of Submission:
Signature: