10+2 / Importer Security Filing

10+2 / Importer Security Filing

Required Shipment Data

vers: Feb 2012

Mode of Transportation / please check applicable: Containerized: □ Break Bulk: □
Container Number: (XXXX1234567 format)
Est. Vessel Dept Date / Time / Date ______(mm/dd/yy) Time: ______(23:59 format)
Please note departure time MUST be noted, as it is used to determine timely ISF filing!
Est. Vessel Arr. Date/Time / Date ______(mm/dd/yy) Time: ______(23:59 format)
Vessel Name
Voyage Number
Bill of lading Type / please check applicable: Direct BL: □ House BL: □
Bill of Lading SCAC / Number / HBL: SCAC: ______Number ______
Master/ Direct: SCAC: ______Number ______
please check applicable: ISF+10 (import) : □ ISF+5(transit): □
Shipment Type / Standard: □ FTZ: □ IE: □ T&E:□ IT: □ FROB: □
Bill of Lading SCAC / Number-enter the bill of lading and the Standard Carrier Alpha Code (SCAC) for this transaction - Pls Note: Master/Direct/House – BL number must match AMS filed number!
Transmission Type- indicate whether this is an ISF+10 or an ISF+5 transaction
Manufacturer / Supplier / Name: / MID #
Addr. 1 / Addr.2
City / State
Postal Code / Country
Phone #
Seller: / Name: / Phone #
Addr. 1 / Addr.2
City / State
Postal Code / Country
Phone #
Container Stuffing Location / Break Bulk Packaging Location / Name: / Phone #
Addr. 1 / Addr.2
City / State
Postal Code / Country
Consolidator: / Name: / Phone #
Addr. 1 / Addr.2
City / State
Postal Code / Country
Buyer / Name: / Phone #
Addr. 1 / Addr.2
City / State
Postal Code / Country
Ship-To: / Name: / Phone #
Addr. 1 / Addr.2
City / State
Postal Code / Country
Note: Addr.1 = Street and House Number Addr.2 = Suite / Apartment Number
Importer of Record: / Name / Phone#
Addr.1 / Addr.2
City / State
Postal Code / Country
CBP assigned # / Format as “123456-78901”
IRS# (FEIN) / Format as “12-3456789”
SS# / Format as “123-45-6789”
Passport# / Country of Issuance
DOB: (mm/dd/yyyy)
Bond Holder:
Single Transaction ISF Bond only: / Name: / Addr.:
City / State
Postal Code / Country
IRS# or SS#
Bond Holder : / please check applicable:Importer/Broker: □ ISF: □ Bonded Cargo: □ FTZ: □
Bond Type: / please check applicable: Continuous : □ Single Transaction: □
Surety Code: / Bond Ref. #
Consignee: / Name / Phone #
Addr.1 / Addr.2
City / State
Postal Code / Country
CBP assigned # / Format as “123456-78901”
IRS# (FEIN) / Format as “12-3456789”
SS# / Format as “123-45-6789”
Passport# / Country of Issuance
DOB: (mm/dd/yyyy)
Note:
For Importer of Record or Consignee: One is required: CBP# or IRS# or SS# or Passport Information –
in this order!!!

Product List:

# / Description: / Commodity Code
(HTSUS- min 6 digits) / Country of Origin / Part Number
(if available)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16

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