Approved through OMB No. 1515-0158

1.  Identifying Number

2.  Name of Company or Individual

DEPARTMENT OF THE TREASURY 

United States Customs Service

HARBOR MAINTENANCE FEE
QUARTERLY SUMMARY REPORT

3.  Complete Mailing Address

4.  REPORTING PERIOD

Jul. 1 -

Jan. 1 -

Apr. 1 -

Oct. 1 -

Year

(One Quarter Only)

19 CFR 24.24

U.S. CUSTOMS SERVICE
P.O. BOX 70915
CHICAGO, IL 60673-0915

Number

Number

Check here if address has changed since last filing.
1

Mar. 31

Jun. 30

Sep. 30

Dec. 31

2
3
4

SEND TO:

Department of the Treasury, United States Customs Service. Harbor Maintenance Fee Quarterly Summary Report 19 C F R 24 . 24 Approved through O M B Number 1 5 1 5 - 0 1 5 8 Send To:  U.S. CUSTOMS SERVICE, P O BOX 70915, CHICAGO, ILLINOIS 6 0 6 7 3 - 0 9 1 5 1.  Identifying Number (One Quarter Only) 4. Reporting Period Any data typed after screen scrolls will not print.

Customs Form 349 (06/02)

Customs Form 349 (0 6/0 2) Form Assistant Page 1 of 3

Form Assistant
Page 1 of 3

Go to Form Assistant Page (1-3):

EIN or IRS
Customs
SSN

(This is a mandatory field)