APPLICATION FOR

EXEMPTION FROM SPECIAL LANDING REQUIREMENTS (OVERFLIGHT)

PHONE

FAX

PHONE

FAX

SURETY NO.

IRS NO.

IRS NO.

SURETY NO.

2. NAME OF OPERATOR (IF LEASED OR DIFFERENT FROM #1)
   (Use Full Legal Name)

1. APPLICANT OR COMPANY NAME AND ADDRESS
   (Use Full Legal Name)

APPLICANT NAME AND ADDRESS

DATE

DENIED

APPROVED

U.S. CUSTOMS ONLY

Please Print or Type

OMB No. 1515-0230

DEPARTMENT OF THE TREASURY
United States Customs Service

Any data typed after screen scrolls will not print.

DATE OF SINGLE (MM/DD/YYYY):

OVERFLIGHT:

CHECK ALL THAT APPLY:            

TERM
SINGLE
AMENDMENT
RENEWAL
NO CHANGE
DELETION
DEPARTMENT OF THE TREASURY UNITED STATES CUSTOMS SERVICE APPLICATION FOR EXEMPTION FROM SPECIAL LANDING REQUIREMENTS (OVERFLIGHT) O M B Number 1 5 1 5 - 0 2 3 0 Please Print or Type   
CHECK ALL THAT APPLY: OVERFLIGHT: APPLICANT NAME AND ADDRESS Data Typed after screen scrolls will not print.

Customs Form 442 (09/02)

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