DEPARTMENT OF HOMELAND SECURITY OMB APPROVAL NO.
1651-0014
EXPIRES: 03-30-2023
U.S. Customs and Border Protection ESTIMATED BURDEN: 45 MIN.
DECLARATION FOR FREE ENTRY OF UNACCOMPANIED ARTICLES
19 CFR 148.6, 148.52, 148.53, 148.77
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 1651-0014. The estimated average time to complete this application is 45 minutes.
The obligation to respond to this information collection is mandatory to obtain benefits. If you have any comments regarding the burden estimate you can write to CBP PRA Officer, U.S.
Customs and Border Protection, Office of Regulations and Rulings, 10th floor, 90K Street NE., Washington DC 20229-1177.
PART I -- TO BE COMPLETED BY ALL PERSONS SEEKING FREE ENTRY OF ARTICLES (Please consult with the CBP official for additional information or
assistance. REMEMBER--All of your statements are subject to verification. False declarations or failure to declare articles could result in penalties.)
1. IMPORTER'S NAME (Last, first and middle initial) 2. IMPORTER'S DATE OF BIRTH 3. IMPORTER'S DATE OF ARRIVAL
Pecha Lee Don 10/01/1960
4. IMPORTER'S U.S. ADDRESS 5. IMPORTER'S PORT OF ARRIVAL
411 East Oklahoma St. Hennessey, 0klahoma 73742 6. NAME OF ARRIVING VESSEL CARRIER AND FLIGHT/TRAIN
7. NAME(S) OF ACCOMPANYING HOUSEHOLD MEMBERS (wife, husband, minor children, etc.)
8. THE ARTICLES FOR WHICH A. DATE B. NAME OF VESSEL/CARRIER C. FROM (Country) D. B/L OR AWB OR I.T.
FREE ENTRY IS CLAIMED NO.
BELONG TO ME AND/OR MY
FAMILY AND WERE IMPORTED
E. NUMBER AND KINDS OF CONTAINERS F. MARKS AND NUMBERS
PART II -- TO BE COMPLETED BY ALL PERSONS EXCEPT U.S. PERSONNEL AND EVACUEES
9. RESIDENCY ("X" appropriate box) A. NAME OF COUNTRY B. LENGTH OF TIME
I declare that my place of residence abroad is was Yr. Mo.
C. RESIDENCY STATUS UPON MY/OUR ARRIVAL ("X" One)
(1) Returning resident of the U.S. (2) Nonresident: a. Emigrating to the U.S. b. Visiting the U.S.
10. STATEMENT(S) OF ELIGIBILITY FOR FREE ENTRY OF ARTICLES. I the undersigned further declare that ("X" all applicable items and submit packing list)
:
A. Applicable to RESIDENT and NONRESIDENT C. Applicable to NONRESIDENT ONLY
(1) All household effects acquired abroad for which free entry is sought (1) All household effects acquired abroad for which free entry is sought
were used abroad for at least one year by me or my family in a were used abroad for at least one year by me or my family in a
household of which I or my family was a resident member during such household of which I or my family was a resident member during such
period of use, and are not intended for any other person or for sale. period of use, and are not intended for any other person or for sale.
(9804.00.05, HTSUSA) (9804.00.05, HTSUSA)
(2) All instruments, implements, or tools of trade, occupation or employment, (2) Any vehicles, trailers, bicycles or other means of conveyance being
and all professional books for which free entry is sought were taken imported are for the transport of me and my family and such incidental
abroad by me or for my account or I am an emigrant who owned and used carriage of articles as are appropriate to my personal use of the
them abroad. (9804.00.10,9804.00.15, HTSUSA) conveyance. (9804.00.35, HTSUSA)
B. Applicable to RESIDENT ONLY
All personal effects for which free entry is sought were taken abroad by me or
for my account. (9804.00.45, HTSUSA)
PART III -- TO BE COMPLETED BY U.S. PERSONNEL AND EVACUEES ONLY
I, the undersigned, the owner, importer, or agent of the importer of the personal and household effects for which free entry is claimed, hereby certify that they
were in direct personal possession of the importer, or of a member of the importer's family residing with the importer, while abroad, and that they were imported
into the United States because of the termination of assignment to extended duty (as defined in section 148.74(d) of the Customs Regulations) at a post or station
outside the United States and the CBP Territory of the United States, or because of Government orders or instructions evacuating the importer to the United
States; and that they are not imported for sale or for the account of any other person and that they do not include any alcoholic beverages or cigars. Free entry
for these effects is claimed under Subheading No. 9805.00.50, Harmonized Tariff Schedule of the United States.
1. DATE OF IMPORTER'S LAST DEPARTURE FROM THE 2. A COPY OF THE IMPORTER'S TRAVEL ORDERS IS ATTACHED AND THE ORDERS WERE
U.S. ISSUED ON:
PART IV -- TO BE COMPLETED BY ALL PERSONS SEEKING FREE ENTRY OF ARTICLES (Certain articles may be subject to duty and/or other
requirements and must be specifically declared herein. Please check all applicable items and list them separately in item D on the reverse.)
A. For U.S. Personnel, Evacuees, Residents and Non-Residents B. For Residents and Non-Residents ONLY
(1) Articles for the account (2) Articles for sale or (7) Foreign household effects (8) Foreign household
effects of other person. commercial use. acquired abroad and used less acquired abroad and used more
than one year. than one year.
(3) Firearms and/or (4) Alcoholic articles of all C. For Resident ONLY ammunition.
types or tobacco products.
(9) Personal effects acquired abroad.
(5) Fruits, plants, seeds, (6) Fish, wildlife, animal (10) Foreign made articles acquired in the United States and taken abroad on meats, or birds.
products thereof. this trip or acquired abroad on another trip that was previously declared to CBP (11) Articles taken abroad for which alterations or
repairs were performed abroad.
CBP Form 3299 (11/19) Page 1 of 2
D. LIST OF ARTICLES
(4) FOREIGN MERCHANDISE TAKEN ABROAD THIS
(1) ITEM NUMBER (3) VALUE OF TRIP: State where in the U.S. the foreign
CHECKED IN PART (2) DESCRIPTION OF MERCHANDISE COST OF merchandise was acquired or when and where it was
IV, A., B., C. REPAIRS previously declared to CBP.
PART V -- CARRIER'S CERTIFICATE AND RELEASE ORDER
The undersigned carrier, to whom of upon whose order the articles described in PART I, 8., must be released, hereby certifies that the person named in Part I,
1., is the owner or consignee of such articles within the purview of section 484(h), Tariff Act of 1930.
In accordance with provisions of section 484(h), Tariff Act of 1930, authority is hereby given to release the articles to such consignee.
1. NAME OF CARRIER 2. SIGNATURE OF AGENT (Print and sign)
Print
Date
Sign
PART VI -- CERTIFICATION TO BE COMPLETED BY ALL PERSONS SEEKING FREE ENTRY
I, the undersigned, certify that this declaration is correct and complete.
1. "X" One
A. Authorized Agent* (From facts obtained from the importer) B. Importer
2. SIGNATURE (Sign in ink) 3. DATE
*An Authorized Agent is defined as a person who has actual knowledge of the facts and who is specifically empowered under a power of attorney to execute this
declaration (see 19 CFR 141.19, 141.32, 141.33).
PART VII -- CBP USE ONLY 1. SIGNATURE OF CBP OFFICIAL (Sign in ink) 2. DATE
(Inspected and Released)
CBP Form 3299 (11/19) Page 2 of 2
