BOND APPLICATION

Name:

Date and time *

Next Year Estimated Duties: *

Next Year Value of Merchandise: *

Next Year Number of Entries: *

Previous Year Number of Entries: *

Previous Year Estimated Duties: *

Previous Year Value of Merchandise: *

Has any surety ever suffered a loss on Principal's behalf? *

Yes

No

Does the Importer require a Reconciliation Rider? *

Yes

No

Is the Importer on Periodic Monthly Statement? *

Yes

No

If Yes, Termination Date:

Has termination been sent on current Bond? *

Yes

No

Is a current Bond on file with Customs? *

Yes

No

Is Merchandise subject to Antidumping/Countervailing duties? *

Yes

No

Country(ies) of Origin: *

Description of Merchandise: *

Years in Business: *

Bond Amount Requested: *

Activity Code: *

Phone: *

Mailing Address *

Physical Address *

Co-Principals/Users *

Yes

No

If Proprietorship Indicate Name of Sole Proprietor:

If Partnership indicate if: *

General

Limited

Entity type: *

Corporation

Partnership

Proprietorship

Individual

DBA:

Name: *

Email: *

Importer Name: *

Importer Number: *

Ph: (786) 477-7600
Fx: (786) 477-7606

5600 NW 36 ST # 266B

Miami, FL 33166

Ph: (786) 477-7600Fx: (786) 477-7606​

5600 NW 36 ST # 266B

Miami, FL 33166

Ph: (786) 477-7600
Fx: (786) 477-7606