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
Check here if you also want your address updated in the Fines, Penalties, and Forfeitures Office
*NOTE--If a continuous bond is on file, a rider must accompany this change document.
2. IMPORTER NUMBER (Fill in one format):--
2B. Social Security Number
Check here if requesting a
Customs-assigned number and
indicate reason(s). (Check all that apply.)
I have not applied for either number.
2D. Customs-Assigned Number
Any data typed after screen scrolls will not print.
DEPARTMENT OF THE TREASURY
United States Customs Service
(This is a mandatory field)
Customs Form 5106 (030899)
Form Assistant
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