Global Insurance Network Coverholder at LLOYD's
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APPLICATION TO FILE CUSTOMS FORM 301 - CONTINOUS BOND ACTVITY CODE 2
Federal ID Number (IRS #) or SS:
Name of Firm and Address:
If Individual: first, middle, last Name
Business Phone Number:
Business Fax Number:
The Bond Will Cover
check as appropriate
Cartman Container Freight Station
Common Carrier Bonded Warehouse
Foreign Trade Zone Centralized Exam Station
Airport Security For Immediate Export (I.E. 63)
If Common Carrier, state port where you will be transporting merchandise to and from.
From: To:
If Container Station(s) or Proprietor's warehouse(s), give the exact physical location(s) of each.
Location: Location:
Type of Merchandise Handled
check as appropriate
General Merchandise Alcohol Tobacco
Have you been operating as a customs approved custodian (i.e. holding a customs custodial license) in the past or presently?
Please list the Port(s) where you have been approved to operate:
What importer number(s) have/do you use(d) when operating as a customs approved custodian? Please list all numbers:
CERTIFICATION
I certify that the factual information contained in this application is true and accurate and any information provided which is based upon estimates is based upon the best information available on the date of this application.
Name: Title:
Email: Date:

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