In order to secure payment of any duty, tax or charge and compliance with law or regulation as a result of activity covered by any condition referenced below, we, the below named principal(s) and surety(ies), bind ourselves to the United States in the amount or amounts, as set forth below.

OMB No. 1515-0144

BOND NUMBER 1 (Assigned by Customs)

FILE REFERENCE

CUSTOMS BOND

19 CFR Part 113

Execution Date

SECTION I--Select Single Transaction OR Continuous Bond (not both) and fill in the applicable blank spaces.

Date of transaction

Port code

Identification of transaction secured by this bond (e.g., entry no., seizure no., etc.)

SINGLE TRANSACTION BOND

Effective date

This bond includes the following agreements. 2 (Check one box only, except that, 1a may be checked independently or with 1, and 3a may be checked independently or with 3.  Line out all other parts of this section that are not used.

United States Customs Service

CONTINUOUS 

BOND

This bond remains in force for one year beginning with the effective date and for each succeeding annual period, or until terminated.  This bond constitutes a separate bond for each period in the amounts listed below for liabilities that accrue in each period. The intention to terminate this bond must be conveyed within the period and manner prescribed in the Customs Regulations.

SECTION II--

Activity Code

Activity Name and Customs Regulations in which conditions codified

Limit of Liability

Limit of Liability

Activity Code

Activity Name and Customs Regulations in which conditions codified

1

2

3

4

3a

1a

6

7

8

9

5

10

Importer or broker . . . . . . . . . . . . . . . . .   113.62

Drawback Payments Refunds . . . . .      113.65

Custodian of bonded merchandise . . . .       113.63

International Carrier . . . . . . . . . . . . . . .     113.64

Instruments of International Traffic . .     113.66

Foreign Trade Zone Operator  . . . . . . .        113.73

Public Gauger  . . . . . . . . . . . . . . . . . . . .   113.67

Wool & Fur Products Labeling Acts

Importation (Single Entry Only) . . . . . . .      113.68

Bill of Lading (Single Entry Only)  . . . . .        113.69

Detention of Copyrighted Material

(Single Entry Only)  . . . . . . . . . . . . . . . .    113.70

Court Costs for Condemned Goods
(Single Entry Only) . . . . . . . . . . . . . . . . .    113.72

Neutrality (Single Entry Only)  . . . . . . . .     113.71

(Includes bonded carriers, freight forwarders, cartmen and lightermen, all classes of warehouse, container station operators)

CUSTOMS
USE
ONLY

(mm/dd/yyyy)

United States Customs Service CUSTOMS BOND 19 C F R Part 113 O M B Number 1 5 1 5 - 0 1 4 4 Any data typed after screen scrolls will not print. CUSTOMS 
USE 
ONLY. This is a protected field. In order to secure payment of any duty, tax or charge and compliance with law or regulation as a result of activity covered by any condition referenced below, SECTION 1 Select Single Transaction OR Continuous Bond (not both) and fill in the applicable blank spaces. SECTION 2 This bond remains in force for one year beginning with the effective date and for each succeeding annual period, or until terminated.  This bond constitutes a separate bond for each period in the amounts listed below for liabilities that accrue in each period. Activity Code Activity Name and Customs Regulations in which conditions codified Activity Code Activity Name and Customs Regulations in which conditions codified This bond includes the following agreements. See footnotes 2. we, the below named principal(s) and surety (sureties), bind ourselves to the United States in the amount or amounts, as set forth below. The intention to terminate this bond must be conveyed within the period and manner prescribed in the Customs Regulations. (Check one box only, except that, 1. A. may be checked independently or with 1, and 3. A. may be checked independently or with 3.  Line out all other parts of this section that are not used.

Customs Form 301 (050798)

Customs Form 301 (0 5 0 7 9 8) Form Assistant Page 1 of 6

Form Assistant
Page 1 of 6

Go to Form Assistant Page (1-6):

Any data typed after screen scrolls will not print.