ATA Carnet Application (Please print out - fax or mail in)
A. Applicant Information:
1. Carnet Holder (Corporate or Individual)
______________________________________________________________________________
Address----------------------------___________________________________________
__________________________Phone No. ( ) _____________________
Fax No. ( )______________________
2. IRS no./SS
No.___________________________________________________________________________
_______________________
3.
ParentCompany_________________________________________________________________
_ IRS No.________________________
4. Person Duly Authorized & Title
Phone No. ( )
___________________
Fax No. ( )____________________
4
5. Authorized
Representatives_______________________________________________________________
_________________________
______________________________________________________________________________
_____________________________________
B. Carnet Preparation Info:
6. Goods to be exported as: _______Commercial Samples (CS) ________
Professional Equipment (PE) ______ Exhibitions and Fairs (EF)
7. Approximate date of departure from U.S.
:_________________________________________
_____Gibraltar (Gl) _____Greece (GR) _____Hong Kong (HK) _____Hungary (HU)
_____Iceland (IS) _____lndia (IN)** _____Ireland (IE) _____Israel (IL)
_____Italy (IT) _____Ivory Coast (Cl) _____Japan (JP)
_____Korea (KR)
_____Lebanon(LB)
**only EF item will be admitted.
_____Luxembourg (UJ)
_____Macedonia(MK) _____Malaysia (MY) _____Malta (MT) _____Mauritius (MU)
_____Morocco(MA)
_____Netherlands (NL) _____New Zealand (NZ) _____Norway (NO) _____Poland (PL)
_____Portugal (PT) _____Romania (RO) _____Senegal (SN) _____Singapore (SG)
_____Slovakia (SK) _____Slovenia (SI) _____South Africa (ZA) _____Spain (ES)
_____Sri Lanka (LK) _____Sweden (SE) _____Switzerland (CH)
_____Taiwan(TW)*
_____Thailand (TH)
_____Tunisia (TN)
_____Turkey (TR) _____U.K. (GB)
_____ United States(US)
_____Protectorates of above,
specify
_____Other
_____Algeria (AL)
_____Andorra(AD)
_____Australia (AU) _____Austria (AT) _____Belgium (BE) _____Bulgaria (BO)
_____China(CN)
_____Croatia(HR)
_____Canada (CA)* _____Cyprus (CY) _____Czech Republic (CZ) _____Denmark (DK)
_____Estonia(EE)
_____Finland (Fl) _____France (FR) _____Germany (DE)
ⷢonly certain PE items will b« admitted
8. Indicate the number of expected visits on the line provided beside each:
9. Number of times leaving_________ and re-entering ________ the U.S
10. Transiting Countries
:_____________________________________________________________________________
_______
C. Carnet Returned to you by:
11. ____ Regular Mail 12.______Messenger Pick-up 13. ____ Courier
Service (Be sure to attach a completed airway bill.)
D. Processing Fees:
14. Basic Fee $__________________
15. Expedited Service Fee __________________
16. Additional Counterfoil/Voucher Fee __________________
17. Additional Continuation Sheets Fee __________________
18. Shipper's Export Declaration Fee (see Carnet instruction Booklet for
details) __________________
19. Refundable Claim Deposit (for government agencies only, see Step 4)
___________________
TOTAL PROCESSING FEE $__________________
Continued on Page 2.
Carnet Application
E. Security:
20._____ Cash-Amount $___________ 21. ____ Bond-Amount $____________ 22.
_____ Written Agreement (Members Only)
In connection with this security, I, as Carnet Holder, agree that the
security I have posted as guarantee may be drawn upon to reimburse the U.S.
Council for such duties, taxes, charges, and costs incurred by the U.S.
Council as a result of my failure to comply with all U.S. Customs or
Foreign Customs conditions as required by all ATA Conventions, and with all
instructions issued by the U.S. Council on the use of my ATA Carnet, or as a
result of any breach of the Carnet system. I further agree to reimburse the
U.S. Council for any payments made on my behalf that may exceed my security
amount. I also understand that if the Carnet is surrendered to the U.S.
Council with all used and unused counterfoils/vouchers and the U.S. Council
has determined that it has been correctly utilized, the U.S. Council may
release me from the guarantee I have furnished prior to the 30 month period.
F. Obligation:
In connection with the use of this carnet, I, as the Holder of the Carnet and
my representative(s), undertake to timely repatriate under Carnet all of the
goods taken abroad, to produce satisfactory and timely evidence to cancel or
mitigate any claim issued against my Carnet by a foreign guaranteeing
association, to comply with all Customs regulations and requirements both in
the United States and abroad, and to accept responsibility for the results of
the negotiations or proceedings with any Customs Authority conducted by me as
Holder or by the U.S. Council on my behalf. I further agree to return the
Carnet to the U.S. Council with all used and unused counterfoils/vouchers
within 15 days after my final trip by receipted mail and to retain a copy
for my records
I declare that I have read all of the contents of the application package
and that all my statements in connection with this application, and the
descriptions and items on the General List, are true and correct.
23._____________________________________________________________________Date__
_______________________________________
(Corporate Officer or Duly Authorized Signature)
Return to RESOURCE PAGE