Free CBP Form 1304 - Crew's Effects Declaration - Federal

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection
19CFR 4.7(a), 4.7a(b)

OMB 1651-0020 Exp. 12-31-2011
Page No.

CREW'S EFFECTS DECLARATION
1. Name of ship 3. No. 4. Family name, given name 2. Nationality of ship 5. Rank or rating 6. Articles acquired abroad by officers and members of the crew (except those exclusively for use on voyage or cleared through U.S. Customs and Border Protection authorities)

7. No. of crewmember's declaration of articles intended to be landed (if none, show "NONE opposite name)

8. Date and signature by master, authorized agent or officer 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 1651-0020. 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 1304 (06/09)