VESSEL ENTRANCE OR CLEARANCE STATEMENT

DEPARTMENT OF THE TREASURY

OMB. No. 1515-0060

TRADE CODES (see back)

1. Manifest No.

2. Port Arrival/Departure

3. Date & Time of Arrival/Departure

4. Vessel Operating Draft (in feet and inches)

Check One:

5. Nationality, Name and Type of Vessel

6. Vessel Built at/Year

7. Name, Address & Phone No. of Ship's Agent

8. Name & Country of Owner

9. Name & Country of Operator

10. Gross Tonnage

11. Net Tonnage

12. Port Arrived From/Departed For

13. IMO #

Official #

Call Sign

14. List All Dock Locations

19 CFR Part 4

ft.

in.

United States Customs Service

O M B Number 1 5 1 5 - 0 0 6 0
DEPARTMENT OF THE TREASURY 
United States Customs Service
VESSEL ENTRANCE OR CLEARANCE STATEMENT 
19 C F R Part 4 Any data typed after screen scrolls will not print. TRADE CODES (see back) Check One: 4. Vessel Operating Draft (in feet and inches)
ENTRANCE
CLEARANCE
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