IMPORTER ID INPUT RECORD

Approved through OMB NO. 1515-0191. 

See back of form for Paperwork Reduction Act Notice.

1. TYPE OF ACTION (Mark all applicable)

Notification of importer's number

Change of address*

Check here if you also want your address updated in the Fines, Penalties, and Forfeitures Office

Change of name*

*NOTE--If a continuous bond is on file, a rider must accompany this change document.

19 CFR 24.5

2. IMPORTER NUMBER (Fill in one format):--

2A. I.R.S. Number

2B. Social Security Number

Check here if requesting a 

Customs-assigned number and

indicate reason(s). (Check all that apply.)

I have no 

Social Security No.

I have not applied for either number.

I am not a 

U.S. resident

2C.

I have no IRS No.

2D. Customs-Assigned Number

3. Importer Name

5. DIV/AKA/DBA Name

4. DIV/AKA/DBA

Any data typed after screen scrolls will not print.

DEPARTMENT OF THE TREASURY 
United States Customs Service

DIV

AKA

DBA

(This is a mandatory field)

DEPARTMENT OF THE TREASURY
United States Customs Service IMPORTER ID
INPUT RECORD
19 C F R 24.5 Approved through O M B Number 15 15-01 91.  See back of form for Paperwork Reduction Act Notice. Any data typed after screen scrolls will not print. 1. TYPE OF ACTION (Mark all applicable) *NOTE--If a continuous bond is on file, a rider must accompany this change document. 2. IMPORTER NUMBER (Fill in one format):-- 4. D I V/ A. K. A. / D B. A.

Customs Form 5106 (030899)

Customs Form 51 06 (0 3 0 8 9 9) Form Assistant Page 1 of 3

Form Assistant
Page 1 of 3

Go to Form Assistant Page (1-3):