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CBP FORM 3461

Entry/Immediate Delivery

PART 1: ARRIVAL INFORMATION

1. Port of Entry

2. Entry Number

3. Entry Date

4. Arrival Date

5. Importer Number

6. Bond Number

PART 2: IMPORTER INFORMATION

7. Importer Name

8. Importer Street Address

9. City

10. State

11. ZIP Code

12. Phone Number

13. Employer Identification Number (EIN)

PART 3: CONSIGNEE INFORMATION

14. Consignee Name

15. Consignee Street Address

16. City

17. State

18. ZIP Code

PART 4: SHIPMENT DETAILS

19. Bill of Lading/AWB Number

20. Carrier Code

21. Vessel/Flight/Trip Number

22. Country of Origin

23. Number of Packages

24. Gross Weight (kg)

25. Description of Merchandise

26. Invoice Value (USD)

27. HTS Tariff Number

PART 5: BROKER INFORMATION (if applicable)

28. Broker Name

29. Broker License Number

30. Broker Phone Number

PART 6: DELIVERY LOCATION

31. Delivery Street Address

32. City

33. State

34. ZIP Code

PART 7: SIGNATURE

35. Signature (Type Full Name)

36. Title

37. Date