United States Customs Service
1. IRS Identification No.
4. Name of Contact Person
2. Name of Warehouse Facility
A.
Entry No.
and Date of
Importation
B.
Description of Merchandise
G.
Beginning
Inventory
Quantity
H.
Ending
Inventory
Quantity
I.
Date Entry
Closed and
Forwarded to
Customs
BONDED WAREHOUSE PROPRIETOR'S SUBMISSION
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(This is a mandatory field)
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