1. ZONE NO. AND LOCATION (Address)
21. FOR THE FTZ OPERATOR: (Signature)
20. TO THE PORT DIRECTOR OF CUSTOMS:
17. PORT DIRECTOR OF CUSTOMS: By (Signature)
The application made above is hereby approved and permission is granted to manipulate, manufacture, exhibit, destroy, or temporarily removed, as requested, on condition that the applicable regulations are complied with and the records required to be maintained will be available for inspection.
APPROVED BY FOREIGN- TRADE ZONE OPERATOR
If any merchandise is to be manipulated in any way or manufactured, I agree to maintain the records provided for in sections 146.21(a), 146.23, and 146.52(d) of the Customs Regulations and to make them available to customs officers for inspection.
4. TYPE OF ACTIVITY FOR WHICH PERMIT REQUESTED
Approved through OMB No. 1515-0086.
DEPARTMENT OF THE TREASURY
United States Customs Service
APPLICATION FOR FOREIGN-TRADE ZONE
ACTIVITY PERMIT
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I certify that the goods described herein have been disposed of as directed except as noted below.
(This is a mandatory field)
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ZONE LOT NO. OR UNIQUE IDENTIFIER
DESCRIPTION OF MERCHANDISE
5. FULL DESCRIPTION OF THE ACTIVITY (Include designation of the exact place in zone where the operation is to be performed and, in the case of a proposed manipulation or
manufacture, a statement as to whether merchandise with one zone status is to be packed, commingled, or combined with merchandise having diffrent zone status. If additional
space required, attach separate sheet. If first application for manufacturing of this kind, state whether Foreign-Trade Zones board has occurred in proposed operation.)