DEPARTMENT OF THE TREASURY
United States Customs Service
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7. Broker ID Number (CF4811)
12. Total I.R. Tax Claimed
11. Puerto Rico Drawback Claimed
10. Total Drawback Claimed
19. Contact Name, Address, Phone & Fax Numbers of Preparer
18. Name and Address of Claimant
Customs Form 7551 (08/01)
Form Assistant
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