Free CBP Form 26 - Report of Diversion - Federal

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection
REPORT OF DIVERSION
19 CFR 4.91 (a) and (b)

OMB No. 1651-0025 Exp. 10-31-2011

1. PORT WHICH GRANTED CLEARANCE OR PERMIT TO PROCEED 3. NAME OF VESSEL

2. NATIONALITY (American or Foreign) 4. RIG 5. DATE

CBP PORT DIRECTOR

6. NAME OF PORT TO WHICH CLEARED 8. ACTUAL/EXPECTED PORT OF ARRIVAL

7. DATE OF CLEARANCE 9. DATE OF ARRIVAL

PLEASE NOTIFY THE PORT DIRECTOR AT THE PORT OF ARRIVAL. (The port director will act only when timely notified under section 4.91(a), and 4.91(b), of the Customs Regulations) AND/OR GRANT RELIEF FROM ANY PENALTY TO WHICH THE MASTER OWNER OR AGENT MAY BE LIABLE UNDER 46 U.S.C. 91 CR 19 U.S.C. 1445. 10. REASONS

11. REPORT SUBMITTED BY 14. PENALTY CASE NUMBER 16. PENALTY ASSESSED AGAINST 18. RECOMMEND THAT THE PENALTY BE

12. TITLE (Owner, Master, or Agent)

13. DATE 15. AMOUNT OF PENALTY

Port 17. SECTION OF LAW VIOLATED

$
Mitigated to

Remitted 19. CBP PORT DIRECTOR BY

$
20. DATE

21. PURSUANT TO THE AUTHORITY CONTAINED IN 19 U.S.C. 1618 OR 46 U.S.C. 7, THE ABOVE PENALTY IS Remitted Mitigated to 22. SIGNATURE OF CBP PORT DIRECTOR BY

$
23. DATE

NOTE: No notice of remission will be furnished. If no notice is received within 30 days, the petitioner may presume that penalty has been remitted. 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 1651-0025. The estimated average time to complete this application is 5 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.

CBP Form 26 (06/09)