Free CBP Form 1300 - Vessel Entrance or Clearance Statement - Federal

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection VESSEL ENTRANCE OR CLEARANCE STATEMENT
See back for Instructions 19 CFR Part 4

Approved OMB. No. 1651-0019 Exp. 12-31-2011

1. Manifest No.

2. Port Arrival/Departure

Check One: TRADE CODES (see back) 1 2 3 4 5 6 3. Date & Time of Arrival/Departure 4. Vessel Operating Draft (in feet and inches) ft. in. 7. Name, Address & Phone No. of Ship's Agent

ENTRANCE

CLEARANCE

5. Nationality, Name and Type of Vessel

6. Vessel Built at/Year

8. Name & Country of Owner

9. Name & Country of Operator

10. Gross Tonnage 11. Net Tonnage 12. Port Arrived From/Departed For 14. List All Dock Locations (continue on back if necessary)

13. IMO #

Official #

Call Sign

15. Particulars of Voyage (Previous and subsequent Ports of Call, include dates; underline where remaining cargo will be discharged) (Con't on back) 16. Brief Description of Cargo 17.
Check if Incomplete Manifest for Export Check if Licensed Cargo Loaded Check if Complete Manifest filed for Export

18. No. of Crew 19. No. of Passengers 20. List All Carriers on board by SCAC Code 21. Tonnage Mark None Submerged Not Submerged 23. Load Line Expires 22. Bunkers: Type, Barrels, Value 25. Passengers Allowed Per Coast Guard Certificate 26. No. of Passengers Embarking/Disembarking

24. Solas Certificate Expires

27. Cert. Of Fin. Resp. No. (Water Pollution) 28. Cert. Of Fin. Resp. (Passenger Death/ and Exp. Date Injury) 30. PURPOSE OF ENTRANCE OR CLEARANCE
D (Discharge Foreign Cargo) F (FROB - Foreign Cargo to Remain on Board)

29. Cert. Of Fin. Resp. (Passenger Transportation Indemnification)

X (Export Cargo Aboard on Arrival) N (No Cargo transactions)

L (Lade Cargo for Export) Y (Military Cargo for Discharge/to be Laden)

31. Print and Sign Name of Master, Authorized Agent or Officer, Date
FOR CBP USE ONLY

32.

CBP User Fee Paid Up*

33.

APHIS User Fee Paid Up* 36. Total Fees Collected

34.

Tonnage Tax Paid Up *

35. Cash Receipt, CBP 368 or Transaction No. 38. CBP Officer Remarks

37. Port Entered/Cleared, Time and Date

39. Signature and Title of Officer Receiving Entry/Granting Clearance *Check boxes only if fees not collected CBP Form 1300 (06/09)

INSTRUCTIONS
Trade Codes: Please enter the code that best describes the arriving or departing vessel (1) Foreign in Ballast (2) Foreign Bulk (3) Foreign General Cargo Domestic or Coastwise Ballast (4) (5) Domestic or Coastwise Bulk (6) Domestic or Coastwise General Cargo Block 4 - Vessel Operating Draft: (not the design draft) Deepest draft of the vessel on entrance (in feet and inches) Deepest draft of the vessel on clearance (in feet and inches) Block 5 - Vessel Types: List one of the codes and descriptions from below: 111 112 140 150 210 229 310 325 330 333 340 341 Crude Oil Tanker Crude/Products Tanker Tank Barge Other Tanker Bulk/Oil Carrier Bulk Carrier Container Vehicle Carrier General Cargo RO-RO Cargo Dry Cargo Barge Deck Barge 350 410 421 422 431 432 492 493 494 499 600 Passenger Fish Processing & Catching Drilling Ship Tug/Supply Offshore Support Tug/Tow Boat Pushboat Research/Survey Dredger Yacht Other NEI Lakers Vessels

Block 9 - Operator as listed on the Certificate of Financial Responsibility (Water Pollution): unless other verifiable charter or lease arrangement indicates otherwise. Block 14 - Additional Information

Block 15 - Additional Information

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 1651-0019. The estimated average time to complete this application is 30 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 1300 (06/09)(Back)