10. Country of Origin. 18. Missing Docs. 23. Importer No AS. A. Entered Value B. CHGS C. Relationship
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1 ACE Version: DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection ENTRY SUMMARY 8. Importing Carrier 9. Mode of Transport PORTUGAL B/L or AWB No. 13. Manufacturer ID MSCUW CLGIOGOR548SAN 16. I.T. No. 17. I.T. Date 18. Missing Docs 21. Location of Goods/G.O. No. 22. Consignee No. N195-APM TERMINALS VIRSAME 25. Ultimate Consignee Name and Address Filer Code/Entry No. BLH ABI/A 07/08/ Surety No. 5. Bond Type 6. Port Code Country of Origin CL 14. Exporting Country AS 1401 REPUBLIC NATIONAL DISTRIBUTING C DIV REPUBLIC NATIONAL DISTRIBUTING WASHINGTON HWY 06/26/2015 CL 06/19/ Foreign Port of Lading Importer No. 26. Importer of Record Name and Address Form Approved OMB No EXP Entry Type 3. Summary Date 7. Entry Date 11. Import Date 06/26/ Export Date 20. U.S. Port of Unlading 24. Reference No. VA City State Zip Description of Merchandise Line A. HTSUS No. A. Gross Weight Net Quantity in No. B. AD/CVD Case No. B. Manifest Qty. HTSUS Units ASHLAND VA City State Zip 32. A. Entered Value B. CHGS C. Relationship 33. A. HTSUS Rate B. AD/CVD Rate C. IRC Rate D. Visa No Duty and I.R. Tax Dollars Cents M W CS NOT RELATED INVOICE WINE 001 RED WINE,>$1.05/L, <=14% ALCHL CL L ( L ) C2500 FREE 0.00 IRT / HARBOR MAINTENANCE FEE 0.125% CARRIED FORWARD Other Fee Summary for Block Total Entered Value HMF $ Total Other Fees 36. DECLARATION OF IMPORTER OF RECORD (OWNER OR PURCHASER) OR AUTHORIZED AGENT $ 36, CBP USE ONLY TOTALS A. LIQ CODE B. Ascertained Duty 37. Duty REASON CODE C. Ascertained Tax 38. Tax D. Ascertained Other 39. Other I declare that I am the importer of record and that the actual owner, E. Ascertained Total 40. Total purchaser, or consignee for CBP purposes is as shown above, OR X owner or purchaser or agent thereof. I further declare that the merchandise X was obtained pursuant to a purchase or agreement to purchase and that the prices set forth in the invoices are true, OR was not obtained pursuant to a purchase or agreement to purchase and the statements in the invoices as to value or price are true to the best of my knowledge and belief. I also declare that the statements in the documents herein filed fully disclose to the best of my knowledge and belief the true prices, values, quantities, rebates, drawbacks, fees, commissions, and royalties and are true and correct, and that all goods or services provided to the seller of the merchandise either free or at reduced cost are fully disclosed. I will immediately furnish to the appropriate CBP officer any information showing a different statement of facts. 41. DECLARANT NAME TITLE SIGNATURE DATE Broker/Filer Information (Name, address, phone number) 43. Broker/Importer File No. Cahill & Dunn CHB, Inc School Street PO Box 200 Culleoka, TN EDITRADE RECORD /104573AS VKJ CBP Form 7501 (06/09)
2 DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection ENTRY SUMMARY CONTINUATION SHEET 1. Filer Code/Entry No. BLH Page: 2 OMB No EXP Description of Merchandise A. HTSUS Rate Duty and I.R. Tax A. Entered Value B. AD/CVD Rate Dollars Cents Line No. A. HTSUS No. B. AD/CVD Case No. A. Gross weight B. Manifest Qty. Net Quantity in HTSUS Units B. CHGS C. Relationship C. IRC Rate D. Visa No. BROUGHT FORWARD INVOICE VALUE ADDITION LESS NDC 0.00 NEV TEV$ EDITRADE RECORD CBP Form 7501 (06/09)
3 FILER DEPARTMENT OF HOMELAND SECURITY OMB No Exp U.S. Customs and Border Protection ENTRY/IMMEDIATE DELIVERY CAHILL & DUNN CHB, INC SCHOOL STREET PO BOX 200 CULLEOKA, TN US CST # CFR 142.3, , , *** ABI CERTIFIED *** 1. ARRIVAL DATE 5. PORT 10. ULTIMATE CONSIGNEE NAME 12. CARRIER CODE 15. VESSEL CODE/NAME 16. U.S. PORT OF UNLADING 20. DESCRIPTION OF MERCHANDISE 2. ELECTED ENTRY DATE 6. SINGLE TRANS. BOND 8. CONSIGNEE NUMBER 13. VOYAGE/FLIGHT/TRIP 17. MANIFEST NUMBER 3. ENTRY TYPE CODE/NAME 7. BROKER/IMPORTER FILE NUMBER 11. IMPORTER OF RECORD NAME 14. LOCATION OF GOODS-CODE(S)/NAME(S) 18. G.O. NUMBER 4. ENTRY NUMBER BLH REPUBLIC NATIONAL DISTRIBUTING C DIV REPUBLIC NATIONAL DISTRIBUTING WASHINGTON HWY ASHLAND, VA AS SAME 9. IMPORTER NUMBER SAME MSCU 522R N195-APM TERMINALS VIRGINI PORTUGAL 19. TOTAL VALUE WINE /104573AS 21. IT/BL/AWB 22. IT/BL/AWB NO. 23. MANIFEST QUANTITY 24. H.S. NUMBER 25. COUNTRY CODE OF ORIGIN 26. MANUFACTURER NO. M MSCUW CL CLGIOGOR548SAN 27. CERTIFICATION I hereby make application for entry/immediate delivery. I certify that the above information is accurate, the bond is sufficient, valid, and current, and that all requirements of 19 CFR Part 142 have been met. 28. CBP USE ONLY SIGNATURE OF APPLICANT X PHONE NO. DATE 29. BROKER OR OTHER GOVT. AGENCY USE Exam Site: FIRMS: N195 TRLU DELIVERY AUTHORIZED: SIGNATURE DATE ELECTRONIC ENTRY - NASHVILLE DISTRICT I certify that this cargo has been authorized for delivery by CBP Cahill & Dunn CHB, Inc. COMPANY NAME Paperwork Reduction Act Statement: An agency may not conduct or sponsor an information collection and a person is not required to respond to this information unless it displays a current valid OMB control number and an expiration date. The control number for this collection is The estimated average time to complete this application is 15 minutes. If you have any comments regarding the burden estimate you can write to U.S. Customs and Border Protection, Office of Regulations and Rulings, 799 9th Street, NW., Washington DC EDITRADE X SIGNATURE DATE CBP Form 3461 (10/09)
4 06/23/2015 Cahill & Dunn CHB, Inc. Page: 1 08:09:35AM ENTRY INVOICE RATING REPORT CATHY Company: CAHILL Office: NASHVILLE File: Entry: BLH Line No Inv Detail Summary CO CE Product Name Product Description HTS Duty Rate Qty UOM NEV S CL CL FRONTERA CAB/MERLOT FRONTERA CAB. SAUVIGNON MERLOT TINTO L Entry Total: 36612
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10 06/22/ :43:46 AM Cahill & Dunn CHB, Inc. Page: 1 CARGO/MANIFEST STATUS QUERY RESULTS JODI File No: Entry No: -- Entry Type: Imp IRS: Vessel: PORTUGAL Carrier: MSCU Voy/Flt/Trip: 522R Arrival Date: 06/25/2015 Entry Port: Bill Of Lading IT No. Issuer Master Issuer House Sub-House Quantity UOM Type MOT ISF MSCU W CAS Regular Ocean Y Status Msg Type Release Date Message Date Time Quantity Sequence ACTION BILL ON FILE 06/19/ :41:00AM ACTION SECFIL ON FILE 06/19/ :44:00PM
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16 CAHILL & DUNN CHB, INC SCHOOL STREET PO BOX 200 CULLEOKA, TN US Tel: Fax: (931) PO/REF #: AS REPUBLIC NATIONAL DISTRIBUTING C WASHINGTON HWY ASHLAND, VA VA DELIVERY ORDER DATE OUR REF.NO. 06/22/ THE MERCHANDISE DESCRIBED BELOW WILL BE ENTERED AND FORWARDED AS FOLLOWS: MSCU W IMPORTING CARRIER LOCATION FROM PORT OF / ORIGIN AIRPORT PORTUGAL-522R B / L OR AWB NO. ARRIVAL DATE FREE TIME EXP. LOCAL DELIVERY OR TRANSFER BY (DELIVERY ORDER ISSUED TO) INLAND CARRIER 06/26/2015 FOR DELIVERY TO REPUBLIC NATIONAL DISTRIBUTING C WASHINGTON HWY ASHLAND, VA VA APM TERMINALS VIRGINIA HAWB NO. ENTRY NO. VALPARAISO, CHILE BRIDGE TERMINAL TRANSPORT BLH ROUTE NOTIFY: ASHLAND RECEIVING CUST.REF.NO AS NO. OF PKGS. DESCRIPTION OF ARTICLES, SPECIAL MARKS & EXCEPTIONS WEIGHT 1280 CS WINE LB I.T. Number: ---- ISSUER/MASTER ISSUER/HOUSE MSCU W Container, Type, Quantity, Seal, Weight TRLU , 45GO, 1280 CS, EU , KGS DO NOT USE INLAND FREIGHT PREPAID / COLLECT COLLECT Received in Good Order By: LIABILITY, INCLUDING NEGLIGENCE IS LIMITED TO THE SUM OF $50.00 PER SHIPMENT, UNLESS A GREATER VALUATION SHALL BE PAID FOR OR AGREED TO BE PAID IN WRITING PRIOR TO DELIVERY CLERK: DELIVER PER KAY JONES ORIGINAL TO CARRIER SHOWN ABOVE
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