Form Ttb F 5620.7 - Claim For Drawback Of Tax On Tobacco Products, Cigarette Papers, And Cigarette Tubes Page 2

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PART III - TTB OFFICER’S REPORT OF INSPECTION (Continued)

12. SIGNATURE OF TTB OFFICER

14. DATE

13. TITLE

PART IV - CUSTOMS CERTIFICATE

SECTION A - CUSTOMS CERTIFICATE OF RECEIPT IN FOREIGN-TRADE ZONE

Except as indicated below all the containers of ar ticles described in Part II, Item 8, w ere received intact in a foreign-trade zone for storage pending sub-

sequent shipment to a f oreign country, Puerto Rico, the U.S. Virgin Islands, or a possession of the United States .

15. FOREIGN-TRADE ZONE LOCATION

16. DATE RECEIVED

17. DISCREPANCIES (if none, so state)

18. SIGNATURE OF CUSTOMS OFFICER

19. TITLE

SECTION B - CUSTOMS CERTIFICATE OF LADING AND EXPORT

The articles described in Part II, Item 8, except as indicated in Item 22, w ere laden and the vessel cleared or depar ted the port as shown below:

20. IDENTITY OF CARRIER ON WHICH LADEN

21. DATE OF LADING

22. DISCREPANCIES (if none, so state)

23. SIGNATURE OF CUSTOMS OFFICER

24. TITLE

25. DATE CLEARED OR DEPARTED

26. SIGNATURE OF CUSTOMS OFFICER

27. TITLE

PART V - POST OFFICE CERTIFICATE

28. U.S. POSTAL SERVICE ENDORSEMENT (Include date of

The shipping containers described in Part II, item 8, were placed in the mail under m y

mailing)

supervision, addressed as indicated in P art I, item 2, and there w as stamped or wr itten

on each shipping container a w aiver signed by the exporter of his/her right to withdraw

such container from the mail.

INSTRUCTIONS

CLAIMANT - The claimant must prepare Part I in connection with each claim f or drawback of tax paid on tobacco products , cigarette papers, or cigarette

tubes, and forward three copies of the executed forms to the Director, National Revenue Center, Alcohol and Tobacco Tax and Trade Bureau, 550 Main St,

Ste 8002, Cincinnati, OH 45202-5215. This form must be accompanied by a bond on TTB F 5200.17.

A TTB officer will inspect the articles, supervise the attachment of the required label on the packages, supervise the packing in shipping containers, and

release the shipping containers to the claimant. The claimant must then execute Part II on all copies of the form and return them to the TTB officer who

will execute Part III on all copies, retain one copy, and furnish two copies to the claimant.

CUSTOMS - Except for exportation through the U.S. Postal Service, the claimant will present these two copies of the form with the shipment to the

Customs Officer at the port of exportation or at the foreign-trade zone, who will execute the appropriate certificate in Part IV, retain one copy for his/her

records, and forward one copy to the National Revenue Center, Alcohol and Tobacco Tax and Trade Bureau shown in Part I.

POSTAL SERVICE - If the shipment is e xported through the U.S. Postal Service, the claimant must stamp or wr ite on each shipping container a signed

waiver of his/her right to withdraw the ar ticles from the mail, present one copy of this form with the shipment to the P ostal Service for the cer tificate in

Part V, and transmit such copy to the National Revenue Center, shown in Part I.

CLAIMANT - In addition to this form the claimant is also required to furnish the National Revenue Center, Alcohol and Tobacco Tax and Trade Bureau

shown in Part I, a lading certificate or other evidence as required by 27 CFR Part 44.

PAPERWORK REDUCTION ACT NOTICE

This request is in accordance with the P aperwork Reduction Act of 1995. The information collection is used to obtain dr awback of taxes on ar ticles which

are exported. This information is required to obtain a benefit b y 26 U.S.C. 5706.

The estimated average burden associated with this collection of inf ormation is 30 minutes per respondent or recordkeeper depending on individual

circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be addressed to the Report

Management Officer, Regulations and Rulings Division, Alcohol and Tobacco Tax and Trade Bureau, Washington, DC 20220.

An agency may not conduct or sponsor, and a person is not required to respond to , a collection of information unless it displays a current, valid OMB

control number.

TTB F 5620.7 (03/2010)