Freestanding Pet Gate

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Specifications:

• Product Name: Freestanding Pet Gate Small
• Manufacturer: Amazon.com Service, Inc
• Country of Origin: Vietnam
• Material: Hevea Brasiliensis
• Quantity: 10 kg

Product Usage Instructions:

Section 1 – Shipment Information:

1. Estimated Date of Arrival: Enter the
expected arrival date (MM/DD/YYYY) of the product.

2. Entry Number: Input the U.S. Customs entry
number provided for this shipment.

3. Container Number: Enter the shipping
container number. If multiple containers, list them in an
attachment.

4. Bill of Lading: Provide the Bill of Lading
number for this shipment.

5. MID: Manufacturer Identification Code is
required.

Section 2 – Compliance with Lacey Act Requirements:

Ensure compliance with the Lacey Act by providing the necessary
information for each article or component.

Section 3 – Plant and Plant Product Declaration Form:

6. Importer Name: Enter the name of the
importing company or individual.

7. Importer Address: Provide the address of the
importer.

8. Consignee Name: Name of the recipient who
will receive the shipment.

9. Consignee Address: Address details of the
recipient.

10. Description of Merchandise: Clearly state
the product name and any specific details about the item.

FAQ:

Q: What should I do if I don’t have a Container Number?

A: If you do not have a container number,
simply leave that section blank in the form.

Q: How do I determine the Estimated Date of Arrival?

A: The Estimated Date of Arrival is the
expected date (MM/DD/YYYY) when the product is anticipated to
arrive in the USA.

Q: What is the significance of the MID (Manufacturer

Identification Code)?

A: The MID is a code provided by the
manufacturer or customs broker to identify the manufacturing source
of the product.

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According to the Paperwork reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0349. The time required to complete this information collection is estimated to average 0.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

OMB APPROVED 0579-0349 Exp. Date:

SECTION 1 – Shipment Information
1. ESTIMATED DATE OF ARRIVAL: (MM/DD/YYYY)

2. ENTRY NUMBER:

3. CONTAINER NUMBER:

See Attachment

4. BILL OF LADING: 5. MID:

Plant and Plant Product Declaration Form
Section 3: Lacey Act Amendment (16 U.S.C. 3372)

6. IMPORTER NAME: Amazon.com Service, Inc 7. IMPORTER ADDRESS:
410 Terry Ave N, Seattle, WA 98121

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
10. DESCRIPTION OF MERCHANDISE: B000AQPSC4 Freestanding Pet Gate Small

8. CONSIGNEE NAME: Amazon.com Service, Inc 9. CONSIGNEE ADDRESS:
410 Terry Ave N, Seattle, WA 98121

SECTION 2 – Compliance with Lacey Act Requirements (16 U.S.C. 3372(f))

For each article or component of an article, provide the following:

11. HTSUS NUMBER: 12. ENTERED 13. ARTICLE/ COMPONENT OF ARTICLE

(no dashes/symbols)

VALUE:

14. PLANT SCIENTIFIC NAME:

Genus

Species

4 4 2 19 9 9 8 8 0

Freestanding Pet Gate Small 94135

HEVEA

BRASILIENSIS

15. COUNTRY 16. QUANTITY OF 17. UNIT: 18. PERCENT

OF HARVEST: PLANT MATERIAL:

RECYCLED:

VIETNAM 10

kg

0

kg

Version 08-15-2011-0856 PPQ FORM 505 AUGUST 2011

I certify under penalty of perjury that, to the best of my knowledge and belief, the information furnished is true and correct:

972-641-9792

Noriko Scott

Preparer’s Phone Number and Area Code

Signature

Type or Print Name

Knowingly making a false statement in this Declaration for Importation may subject the declarant to criminal penalties in accordance with 16 U.S.C. 3373(d).

12/12/2023
Date

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Version 08-15-2011-0856
1. Estimated Date of Arrival: Enter the date (MM/DD/YYYY) that the product is expected to enter the United States of America.
2. Entry Number: Enter the U. S. Customs entry number assigned to this shipment. (Format: xxx-xxxxxxx-x)
3. Container Number: Enter the number of the shipping container in which the product is being shipped – available from your shipping company. If you have more than container number in your shipment, check the “see attachment” box, and list all of the containers on a separate sheet. Attach the container list to the PPQ 505. If there is no container number, please leave this section blank.
4. Bill of Lading: Enter the Bill of Lading (BOL) number assigned to this shipment – available from the shipping company. If there is no Bill of Lading number, please leave this section blank.
5. MID: Manufacturer Identification Code – available from the manufacturer or customs broker (19 CFR Appendix to Part 102).
6. Importer Name: Enter the name of the import company or individual for the product.
7. Importer Address: Enter the address of the import company or individual in

6.

8. Consignee Name: Name of the individual or company who ordered and will ultimately receive the shipment.
9. Consignee Address: Enter the address of the individual or company in #8.
10. Description of the Merchandise: Enter the name of the plant or plant product, and its use (example: wooden spoons for kitchenware). If the use is unknown, enter only the name of the product(example: lumber). If the product is protected under CITES also input CITES permit number here. If product was manufactured prior to the Lacey Act Amendment also input “Manufactured Prior to May 22, 2008”.
11. HTSUS Number: Enter the Harmonized Tariff Code for the merchandise described in #10 – available at http://www.usitc.gov/tata/hts/.
12. Entered Value (in U.S. Dollars): Write the entered value of the imported merchandise described in #10 in U.S. Dollars.
13. Article/Component of Article: Enter a brief description of each article, or component of an article, that is manufactured from plants or plant parts. (Example: A decorative item including a wood frame and 100 % recycled paperboard – enter the frame as a line item, and record the percent recycled material in the paperboard in section #18.)
14. Plant Scientific Name: For each article/component in #13 enter the scientific name (example: See next page). If the species of plant used to produce the product varies, and the species used to produce the product is unknown, enter each species that may have been used to produce the product. If product was manufactured prior to the Amendment and you cannot determine species, enter “Special” for Genus and “PreAmendment” for Species. The Scientific Name is NOT the trade/common name of the plant.
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Version 08-15-2011-0856
15. Country of Harvest: Enter the country where the plant was harvested (example: See below). If the country of harvest varies, and is unknown, enter all countries from which the plant material in the product may have been harvested. This is NOT the country of manufacture/origin.
16. Quantity of Material: How much plant material is in the shipment (example: See below).
17. Unit: This is the Unit of Measure of the Plant Material. Use the drop down box on the form to enter the units for #17. (example: See below).
kg – kilograms m – meter m2 – square meters m3 – cubic meters

18. % Recycled Material: If the product is paper or paperboard, enter the percentage of recycled material it contains (0 – 100%). If the percentage of recycled material varies, enter the average percentage of recycled material used in the product (example: If the percentage of recycled material used is between 25% and 45%, enter 35%).

11. HTSUS Number
9401692010

12. Entered Value
1354

13. Article/Component of Article Bentwood Seats Made of Oak

14. Plant Scientific Name

Genus

Species

Quercus

lineata

15.Country of Harvest
Indonesia

16. Quantity of Plant Material

17. Unit

18. Percent Recycled

500

kg

0

4407950000

8442

European ash lumber (2″ x 4″)

Fraxinus

excelsior

Switzerland

52

M3

0

Submission of Paper Declaration: Importers should have a copy of the form available for Customs and Border Protection (CBP) to review at the port of entry. After CBP clears the shipment, the importer must mail the original form to the USDA at the following address:

The Lacey Act c/o U.S. Department of Agriculture Box 10 4700 River Road Riverdale, MD 20737

Note:

You may use Form PPQ 505B should more space be required. Make as many copies as necessary. Failure to include any and all of the required information will result in the rejection of your declaration.

SPECIAL NOTE: IF YOU HAVE FILED A LACEY ACT DECLARATION ELECTRONICALLY THROUGH THE CUSTOMS SYSTEM, THERE IS NO NEED TO FILE A PAPER DECLARATION.

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