19 CFR 10.8, 10.9, 10.68,
148.1, 148.8, 148.32, 148.37
NAME, ADDRESS, AND ZIP CODE TO WHICH CERTIFIED FORM IS TO BE MAILED (If Applicable)
(NOTE: Number of copies to be submitted varies with type of transaction.
Inquire at Port Director's office as to number of copies required.)
Form Approved. OMB No. 1515-0042
CERTIFICATE OF REGISTRATION
DEPARTMENT OF THE TREASURY
United States Customs Service
* NOTE: The cost or value of alterations, repairs, or processing
abroad is subject to customs duty.
Any data typed after screen scrolls will not print.
Customs Form 4455 (06/00)
Form Assistant
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