CERTIFICATION OF FOREIGN TRADE ZONE OPERATOR
The merchandise described in the entry was received from ____________ on __________________, 19____; in Foreign Trade Zone No.____________,
(City and State)
Exceptions ____________ _______________________________
(Name and title)
By ____________ _______________________________
(Name of operator)
TRANSFEROR'S DECLARATION
I, ____________________ _______________________________
of the firm of____________________, declare that the merchandise described in this entry was duly entered at the customhouse on arrival at this port; that the duties thereon have been paid as specified in this entry; and that it was transferred to Foreign Trade Zone No. ______, located at ____________, (City and State) for the sole purpose of exportation, destruction, or storage, not to be removed from the foreign trade zone for domestic consumption. I further declare that to the best of my knowledge and belief, this merchandise is in the same quantity, quality, value, and package, unavoidable wastage and damage excepted, as it was at the time of importation; that no allowance nor reduction of duties has been made for damage or other cause except as specified in this entry; and that no part of the duties paid has been refunded by drawback or otherwise.
Dated: _______________________________
(Transferor)
19 C.F.R. §191.184