DEPARTMENT OF HOMELAND SECURITY OMB No. 1651-0003 Exp.

12-31-2010
U. S. Customs and Border Protection
TRANSPORTATION ENTRY AND MANIFEST OF GOODS
SUBJECT TO CBP INSPECTION AND PERMIT
Entry No.

Class of Entry
CONTINUATION SHEET

(I.T.) (Wd. T.) (Wd. Ex.) (T.E.) (Drawback, etc.)

Marks and Description and Quantity of Merchandise, Gross Weight Value
Numbers of Number and Kind of Packages Rate Duty
in Pounds (Dollars only)
Packages (Describe fully as per shipping papers)

THIS FORM MAY BE PRINTED BY PRIVATE PARTIES PROVIDED IT CONFORMS TO THE OFFICIAL FORM IN SIZE, WORDING, COLOR, AND ARRANGEMENT.
See CBP Form 7512 for Paperwork Reduction Act Notice CBP Form 7512A (03/08)
 INSPECTOR'S REPORT OF DISCHARGE AT DESTINATION
Port Station Date

To the Port Director of CBP: Delivering Line Car No. Initial

Arrived Condition of Car Of Seals Of Packages

Date of Delivery to No. and Kind of Entry or Bonded Truck or

Importer or General Packages Conditions, Etc.
General Order Lighter No.
Order

I certify that the above report is correct.

Inspector's Name: Signature: X

CBP Form 7512A (03/08)(Back)