Cbp Form 226 - Record Of Vessel Foreign Repair Or Equipment Purchase

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U.S. DEPARTMENT OF HOMELAND SECURITY
Form Approved, OMB No 1651-0027--See back of form for Paperwork Reduction Act Notice.
1. FUNCTION OF THIS DOCUMENT
(Mark only one)
ITEMS BELOW FOR ENTRY ONLY; DO NOT USE FOR DECLARATION
Bureau of Customs and Border Protection
18. ENTRY NUMBER AND DATE
DECLARATION
RECORD OF VESSEL
(Complete Items 1 through 16 Only)
FOREIGN REPAIR OR EQUIPMENT PURCHASE
ENTRY
19 CFR 4.7, 4.14
(Complete Items 1- 15 and 19-25)
2. OWNER NAME AND ADDRESS
3. REPRESENTED LOCALLY BY
19. NAME OF PRINCIPAL AND SURETY
4. VESSEL NAME
5. NAME OF MASTER
6. PORT ARRIVED FROM
7. VOYAGE NO.
8. U.S. PORT OF ARRIVAL
9. PORT CODE
10. ARRIVAL DATE
20. BOND NUMBER
21. BOND AMOUNT
11.
12.
COST IN FOREIGN MONEY
22.
23.
24.
LOCATION (City and Country) AND DATE OF
DESCRIPTION OF WORK PERFORMED INCLUDING IDENTIFICATION OF
EXCHANGE
ENTERED
DUTY @ 50% ENTERED
14. Labor
13. Material, Parts or
REPAIRS ETC. AND SAILING DATE FROM
MATERIALS/EQUIPMENT PURCHASED
RATE
U.S. COST
COST IN U.S. MONEY
Equipment
THAT COUNTRY
15a. Material, Etc.
15b. Labor
15. TOTAL
AMOUNT DECLARED
25. CERTIFICATION OF MASTER OR AUTHORIZED AGENT OF THE OWNER
ITEMS BELOW FOR DECLARATION ONLY, DO NOT USE FOR ENTRY
16. CERTIFICATION OF MASTER
17. CBP USE ONLY
I HEREBY SUBSCRIBE TO THE STATEMENT RELATIVE
TO AN ENTRY ON THE BACK OF THIS DOCUMENT.
I have examined the vessel's log, which indicates:
AS MASTER OF THE SAID VESSEL, I HEREBY
(Mark Box ''A" or Box ''B')
SUBSCRIBE TO THE DECLARATION STATEMENT
The undeclared repairs or purchases which
No undeclared
A
B
ON THE BACK OF THIS DOCUMENT.
(incomplete)
I have listed on the back of this declaration.
repairs or purchases
(full and complete)
A. SIGNATURE
A. SIGNATURE
C. SIGNATURE
B. TITLE
C. DATE
B. TITLE
C. DATE
D. TITLE
E. DATE
CBP Form 226 (05/96)

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