OMB No. 1651-0033
Expires 08/31/2012
1. IRS Identification No.
4. Name of Contact Person2. Name of Warehouse Facility 3. Address 5. Telephone No.
BREAKAGE
QUANTITY
CERTIFICATION
I hereby certify that the information contained in this submission completely and accurately represents all entry transactions as well as
warehouse facility for the year ending .
(Name)
10. Date7. Signature 9. Name of Company
(Paperwork Reduction Notice and Instructions on reverse)
8. Title
B.
Description of Merchandise
C.
Per Entry
H.
Ending
Inventory
Quantity
beginning and ending inventories of
CBP Form 300 (08/09)
19 CFR 19.12 (a)(5)
G.
Beginning
Inventory
Quantity
A.
Entry No.
and Date of
Importation
D.
Over/Short
on Receipt
E.
Upon Receipt
Quantity
F.
In Warehouse
Quantity
I.
Date Entry
Closed and
Forwarded to
CBP
6. Total Number
of Entries
Reported
DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
BONDED WAREHOUSE PROPRIETOR'S SUBMISSION
A warehouse proprietor is required to file a submission for each warehouse facility. The definition of a warehouse facility is as follows:
A warehouse facility will be determined by street address, location, or both. For example, if a proprietor has two warehouses located at one street address and
three warehouses located at three different street addresses, the two would be considered as one warehouse facility and the three warehouses would each be
considered as separate facilities.
The following instructions are to assist you in preparing the ''Bonded Warehouse Proprietor's Submission''.
All pages must be numbered and contain the facility name. Additionally, the first and last page of the submission must show:
• name of warehouse facility;
• address - warehouse location, not the corporate address or a post office box number;
• telephone number - include the area code;
• IRS number - assigned number;
• contact person - include phone number, if different from the facility number.
The Warehouse Proprietor's Submission form is divided into nine sections labeled A through I.
Column A. Record the entry number and date of importation of all entries which were include in:
1. The beginning inventory of the year just ended.
2. The ending inventory of the year just ended.
3. Also, include all entries which were opened and closed during the year which do not appear in either
the beginning or ending inventory listings.
Column B. Provide an adequate description of all merchandise covered by those entries listed in Column A. The description should be concise but
specific enough to identify the commodity, i.e., "scotch 12 btls/case" rather than "liquor". For entries listing multiple commodities, the term
"various" may be used, however this will not be acceptable for all situations.
Column C. Record in Column C. the quantity stated on the entry for each commodity described in Column B.
Column D. Record any quantity actually received that is over/short that recorded in Column C.
Column E. & F. Record the quantities relating to all breakage occurring upon arrival and/or in the warehouse pertaining to each commodity listed in
Column B.
Column G. Record the quantity of merchandise that is on hand at the beginning of the business year.
Column H. Record the quantity of merchandise that is on hand at the end of the business year.
Column I. Record the date on which the entry was closed and forwarded to CBP.
An authorized representative must sign the document where indicated prior to issuing to CBP.
Paperwork Reduction Act Statement: An agency may not conduct or sponsor an information collection and a person is not required to respond to this
information unless it displays a current valid OMB control number and an expiration date. The control number for this collection is 1651-0033. The
estimated average time to complete this application is 24 hours and 18 minutes. If you have any comments regarding the burden estimate you can
write to U.S. Customs and Border Protection, Office of Regulations and Rulings, 799 9th Street, NW., Washington DC 20229.
The preparation and filling of this submission with the Field Director, Regulatory Audit Division, U.S. Customs and Border Protection is to occur with 45 calendar days
subsequent to the company's year-end. Should you have any questions regarding this submission, contact the Field Director, Regulatory Audit Division at
.
CBP Form 300 (08/09)(Back)
INSTRUCTIONS