Fillable Foreign Shippers Declaration of U.S. Goods Returned

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Foreign Shippers Declaration of U.S. Goods Returned

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The Foreign Shippers Declaration of U.S. Goods Returned form is 1 page long and contains:

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Foreign Shipper’s Declaration of U.S. Goods Returned
I, _________________________________, declare that to the best
of my knowledge and belief that the articles herein specified were
exported from the United States, from the port of ______________
on or about ________________, 20___, and that they are returned
without having been advanced in value or improved in condition
by any process of manufacturing or other means.
Marks Number Quantity Description Value, in U.S. coin
_______________________________
(Date)
_______________________________
(Address)
_______________________________
(Signature)
_______________________________
(Capacity)
Reference: 19CFR 10.1(a)(1)
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Foreign Shippers Declaration of U.S. Goods Returned

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Completed 17 March 2022

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