BSF865 - Exception Temporary Admission Permit - Commercial
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Protected B when completed
- 1 Temporary Permit Transaction No.
- 2 Previous Transaction No.
- 3 Cargo Control No.
- 4 Importer Business No.
- 5 Importer Name
- 6 Importer Address
- 7 Importer Telephone Number
- 8 Broker/Agent Business No
- 9 Broker/Agent Name
- 10 Broker/Agent Address
- 11 Broker/Agent Telephone No.
- 12 Destination in Canada
- 13 Arrival Date
- 14 Estimated Date of Arrival
- 15 Extension Date Description
- 16 Expiry Date
- 17 Extension Date
- 18 Estimated Deposit
- 19 Deposit
- 20 Low Risk Authority
- 21 Low Risk Authority Description
- 22 Use in Canada
- 23 Gross Weight/kgm
- 24 Mode of Transport
- 25 CBSA Office
Declaration Totals
- Value for duty
- 60 Customs duties
- 61 Excise duty
- 62 Excise Tax
- 63 GST
- 64 PST/HST
- 65 Total duties and taxes
- 66 I declare the information contained to be true and complete.
- 67 Importer
- 68 Agent
- 69 Name
- 70 Contact No
- 71 CBSA office stamp
- 73 Remarks
Signature - 72 CBSA Officer
Commodity Details
- Commodity Details
- 26 Vendor Line No.
- 27 Vendor Name
- 28 Vendor Address
- 29 Vendor Telephone No.
Add another section number 30 to 58
- 30 Commodity Line No.
- 31 Narrative Description
- 32 Classification No.
- 34 Quantity
- 35 Unit of Measure
- 36 Country of Origin
- 37 U.S. State
- 38 Place of Export Code
- 39 Place of Export Code State
- 40 Tariff Treatment Code
- 41 Tariff Code
- 42 Value Currency Conversion
- 43 Currency
- 44 Exchange Rate
- 45 Special Authority OIC
- 46 Alcohol Percent
- 47 Value for Duty Code
- 48 Excise Tax Code
- 49 Destination Province
- 50 PST/HST Amount
- 51 GST Code
- 52 Value for Duty
- 53 Customs Duty
- 54 Excise Duty
- 55 Excise Tax
- 56 Value for Tax
- 57 GST
- 58 Commodity Duties & Taxes
IMPORTANT
Privacy Statement
It is important to ensure that the claimant's certification is duly completed by the claimant or his authorized agent and signed.
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