Free CBP Form 349 - Harbor Maintenance Fee Quarterly Summary Report - Federal

Approved OMB No. 1651-0055 Exp. 11/30/2011

DEPARTMENT OF HOMELAND SECURITY

1. Identifying Number

U.S. Customs and Border Protection HARBOR MAINTENANCE FEE QUARTERLY SUMMARY REPORT
19 CFR 24.24

EIN or IRS Number

CBP Number

SSN

2. Name of Company or Individual 3. Complete Mailing Address

SEND TO: U.S. Customs and Border Protection
Office of Finance, Revenue Division 6650 Telecom Drive Indianapolis, IN 46278 4. REPORTING PERIOD Year (One Quarter Only) 5. Value of Shipments Jan. 1 Mar. 31

Check here if address has changed since last filing.

1

2

Apr. 1 Jun. 30

3

Jul. 1 Sep. 30

4

Oct. 1 Dec. 31

Type of Shipment With Class Code

6. Value of Exemptions
(from corresponding columns

7. Net Value (column 5 less column 6)

A to D of line 15) A. Domestic Movements 503 B. FTZ Admissions 505 C. Passengers 504 D. Total Line Value 5, $ 6, & 7

8. HMF Due (multiply the amounts in column 7 by appropriate rate)

$

$ $ D. Total

9. Total HMF Due (Total of Lines 8A through 8C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ITEMIZATION OF EXEMPTIONS 10. Exempt Port 11. Inland Waterway Fuel Tax 12. Intraport 13. U.S. Mainland-State/ Possession/Territory 14. Other 15. TOTALS
(Also enter amounts in 15A thru 15D in 6A thru 6D above).

A. Domestics

B. FTZ(s)

C. Passengers

16. CERTIFICATION I hereby under penalties provided by law that the above information regarding the Harbor Maintenance Fee is completed and accurate to the best of my knowledge. Please Sign Here 17. Type or print name of person who prepared this report (if same as block 2, write "Same") Date

18. Telephone Number

(country code, if applicable)

PRIVACY ACT NOTICE: The Following information is given pursuant of the Privacy Act of 1974 (Pub. L. 93-579). The disclosure of the social security number is mandatory when an Internal Revenue Service number is not disclosed whenever an identification number is requested. Identification numbers are solicited under the authority of Executive Order 9397 and Pub. L. 99-662. The identification number provides unique identification of the party liable for the payment of the Harbor Maintenance Fee. The number will be used to compare on this form with information submitted to the Government on other forms required in the course of shipping, exporting, or importing merchandise, which contain the identification number, e.g., the SED, Vessel Operation Report, to verify that the information submitted is accurate and current. Failure to disclose an identification number may cause a penalty pursuant to 19 CFR 24.24(h). PAPERWORK REDUCTION ACT NOTICE: This request is in accordance with the Paperwork Reduction Act. We ask for the information in order to carry out the Harbor Maintenance Revenue provisions of the Water Resource Development Act of 1988. We need it to ensure that the trade community is complying with this Act, and to allow CBP to determine if the correct amount of Harbor Maintenance Fee (HMF) is collected. It is mandatory. The estimated average burden associated with this collection of information is 30 minutes per respondent plus 10 minutes recordkeeping depending on individual circumstances . Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to U.S. Customs and Border Protection, Asset Management, Washington, DC 20229, and to the Office of Management and Budget, Paperwork Reduction Project (1651-0055), Washington, DC 20503.

CBP Form 349 (03/09)

FORM INSTRUCTIONS
(Refer to Customs publication No. 548, "Preparation of Harbor Maintenence Fee Forms" for additional instructions; and 19 CFR 24.24.) The following are specific instructions for most of the items on the form. Items that have no instructions are self-explanatory. Domestic movements, foreign trade zone (FTZ) admissions, passengers, or any combination of these, may be declared on one form provided the name of the company and identifying number are the same for all movements declared. Item 1. Identifying Number - Individual summary reports may contain only one identifying number. This does not preclude filing more than one summary report for one identifying number. The identifying number must correspond to Item 2, Name of Company or Individual. Check the appropriate box to indicate the kind of identifying number being used. Enter the following information: Domestic Movements - Shipper's Internal Revenue Service (IRS) Number listed on the Vessel Operator Report (U.S. Army Corps of Engineers Form 3925). FTZ Admissions - Applicant for Admission to a Foreign Trade Zone's Internal Revenue Service (IRS) Employer Identification Number (EIN). Passengers - Vessel Operator's Internal Revenue Service (IRS) Employer Identification Number (EIN). Item 2. NAME OF COMPANY OR INDIVIDUAL following information: - Enter the

ITEMIZATION OF EXEMPTIONS
Only one exemption per movement may be claimed. (See definition of "movement" in Item 5 of the General Instructions in Customs Publication No. 548). Figures inserted In Items 10 through 15 shall represent quarterly totals. Item 10. Exempt Port - Total value of shipments, for each type of movement (e.g., domestics, FTZ admissions, etc.), loaded and/or unloaded at an exempt port. See Customs Publication No. 548 "Preparation of Harbor Maintenance Fee Forms" for list of non-exempt ports. Item 11. Inland Waterw ay Fuel Tax - Total value of shipments transported by vessels using fuel subject to the Inland Waterway Fuel Tax. Applies only to domestic movements. Item 12. Intraport - Total value of cargo moved within a single CBP port. Applies only to domestic movements. Item 13. U.S. Mainland-State/Possession/Territory - TotaI value of the following: Cargo, other than Alaskan crude oil, loaded on a vessel in Hawaii, Alaska, or Puerto Rico, and unloaded in the state or territory in which loaded. Cargo, other than Alaskan crude oil, transported from the U.S. mainland to Alaska, Hawaii, Puerto Rico, or the U.S. possessions for ultimate use or consumption: and/or Cargo, other than Alaskan crude oil, transported from Alaska, Hawaii, or any U.S. possession to the U.S. mainland, Alaska, Hawaii, or such possession for ultimate use or consumption in the mainland, Alaska, Hawaii, or such possession. U.S. mainland includes the 48 contiguous states and the District of Columbia. The U.S. possessions and territories include the following: American Samoa Baker Island Guam Howland Island Jarvis Island Johnston Atoll Kingman Reef Midway Northern Marianna Islands including: Agrihan Aguijan Guguan Pagan Rota Saipan Tinian Palmyra Island Puerto Rico U.S. Virgin Islands Wake Island Item 14. Other - The total value of cargo, for each type of movement, subject to the following exemptions: Cargo entering the U. S. in-bond for transportation and direct exportation to a foreign country. (Does not include cargo for which a formal entry or warehouse entry is filed, or cargo which is admitted into a foreign trade zone). Fish and other aquatic animal life caught by a vessel, and not previously landed on shore, regardless of the extent to which it has been processed. Passengers transported on ferries. Ferries are defined as vessels engaged primarily in the transport of passengers and their vehicles between ports in the U.S. or between ports in the U.S. and ports in Canada or Mexico. The vessel must arrive in the U.S. on a regular schedule during its operating season. Item 16. CERTIFICATION - Insert signature of shipper, application for FTZ admission, or operator of passenger carrying vessel.

Domestic Movements - Shipper listed on the Vessel Operator Report (U.S. Army Corps of Engineers Form 3925). FTZ Admissions - Applicant or Firm Name listed on the Application for Foreign Trade Zone Admission and/or Status Designation (CBP Form 214 Box 24). Passengers - Operator of the Passenger Carrying Vessel. Item 3. ADDRESS - Street Address or P. O. Box number, city, state, and zip code where company or individual may be contacted. Item 4. REPORTING PERIOD - Check only one box. A separate summary report is required for each quarter reported. Item 5. VALUE OF SHIPMENTS - Figures inserted in Items 5A through 5C shall represent quarterly totals. (5A) Domestic Movement - Total Value at the time of l oading. (Free Alongside Ship (FAS) value, which includes selling price, inland freight, insurance, and all other charges to transport the cargo to the dock alongside the vessel.) (5B) FTZ Admissions - Total entered value listed on the Application for Foreign Trade Zone Admission and/or Status Designation (CBP Form 214, total of Block 21). (5C) Passengers - Actual charge for transportation paid by the passengers or the prevailing charge for comparable service if no actual charge is paid. The HMF is paid only once per journey for each passenger. Crewmembers are not subject to the HMF. Item 6. VALUES OF EXEMPTIONS - Exemptions are to be itemized in Items 10 through 14. Totals shall be inserted in Items 6A through 6C. Item 7. NET VALUE - Net value shall be calculated by subtracting Items 6A through 6C from Items 5A through 5C. Enter the total net value (sum of Lines A - C, Column 7) on Line E, Columns 5, 6 and 7. Item 8. HMF DUE - To calculate the HMF, multiply the amount on Lines 8A, 8B and 8C times the rate in effect for the period being reported. The rate is 0.0004 (.04%) through December 31, 1990 and 0.00125 (.125%) beginning January 1, 1991. Item 9. TOTAL HMF DUE - Total of lines 8A, 8B and 8C. Remit a check or money order payable to the U.S. Customs and Border Protection. Payments must be received no later than 31 days after the close of the quarter being paid.

CBP Form 349 (03/09)