PS Form 2976-A "Customs Declaration and Dispatch Note - Sample"

What Is PS Form 2976-A?

PS Form 2976-A, Customs Declaration and Dispatch Note - also known as USPS Form 2976-A - is a form used by the United States Postal Service (USPS) as a summary of package contents and their value. This information is necessary for the destination country to examine mail and allow its entry without having to open the parcel and inspect each item one-by-one.

The latest version of this customs declaration was released by the USPS in July 2013 with the previous edition dated September 2012 still valid. A printable PS Form 2976-A is available for reference below or can be found through the USPS forms website.

The PS Form 2967-A is necessary for all Priority Mail International shipments, except packages, destined to military mail within the U.S. Territories. A customs form is not necessary if the package contains only non-negotiable documents or correspondence, weighs under 16 ounces and is being sent with First-Class Mail International service.

The PS Form 2976-A should not be confused with the PS Form 2976-R, USPS Customs Declaration and Dispatch Note. The difference between USPS Form 2976-A and 2976-r is that the USPS 2976-R is never used as a stand-alone customs form. This form is used as a worksheet that retail associates provide with their package and is available only as a hard copy. It serves as a basis for generating the appropriate customs form.

Other related forms include the PS Form 2976-B, PS Form 2976-E, and PS Form 2976-ES.

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What Is the Difference between USPS Form 2976 and 2976-A?

The United States Postal Service uses two customs forms: the USPS Form 2976 and the USPS Form 2976-A. The difference between the forms is mainly in postal services they are used in connection with. The USPS 2976 is necessary for the First-Class Mail International; for First-Class Package International Service items; M-bags and certain Priority Mail Express International items.

How to Fill out USPS Customs Form 2976-A?

  1. FROM field. Enter the information about the sender: full name and full address. You can provide your fax or phone number or email address, which might be necessary to contact you in regards to the package;
  2. TO field. Enter the information about the addressee: full name and full address;
  3. Block 1. Detailed Description of Contents. Provide a detailed description of each article in a package. If the item is named generally, the Form and the package will not be accepted. Additional Forms should be used if the provided space is not enough;
  4. Block 2. Qty. Enter the quantity of each item type given in the previous block;
  5. Block 3. Lbs. Provide the weight of the items in ounces and pounds;
  6. Block 4. Value. Enter the value of the items in U.S. Dollars;
  7. Block 5. Check all boxes that apply, indicating the type of items in the package;
  8. Block 6. Other Restrictions. If the parcel requires any special conditions or there are any restrictions, provide this information;
  9. Block 7. Total Gross Wt. Enter the total weight of all items in a package in pounds and ounces, including the weight of the packaging;
  10. Block 8. Total Value US $. Enter the total value of all items in the package in U.S. Dollars;
  11. Block 9. If non-deliverable. Provide instructions, how to treat the package, if it is not delivered;
  12. Block 10. AES/ITN/Exemption. If applicable, enter an Automated Export System (AES) Internal Transaction Number (ITN) or AES Downtime Citation;
  13. Block 11. Restrictions. If the package contains items, that are subject to quarantine restrictions, indicate this;
  14. Block 12. Sign and date the Form;
  15. Block 13. Sender's Customs Reference. Provide the reference;
  16. Block 14. Importer's Reference - Optional. Provide the reference;
  17. Block 15. Importer's Contact. Select the type of contact and provide it;
  18. Block 16. License No. Enter the number of the license;
  19. Block 17. Certificate No. Provide the certificate number;
  20. Block 18. Invoice No. Provide the invoice number;
  21. Block 19. HS Tariff Number. This block is completed only if the package is commercial. Provide the 6-digit Harmonized Tariff Schedule number;
  22. Block 20. Country of Origin of Goods. This block is required only for commercial packages. Provide the country of origin of mailed items.

How to Order PS Form 2976-A?

USPS customs forms can be obtained in several ways.

Use the USPS Click-N-Ship tool on the USPS website. This tool allows to fill in all the necessary data and the system will automatically choose the proper customs form. Print the completed form. If the Click-N-Ship option is unavailable (because the international service does not support this option) you can generate the form and print it out on the same webpage.

The customs forms can be obtained and filled out at the post office. If necessary, the postal service employees can provide assistance in completing the form.

Download PS Form 2976-A "Customs Declaration and Dispatch Note - Sample"

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INSTRUCTIONS FOR COMPLETING THIS FORM (Remove this page prior to completing form.)
Please print this form in English using blue or black ink, pressing firmly so all information transfers to all copies. Complete the
declaration fully and legibly; otherwise, delay and inconvenience may result for the addressee. A false or misleading declaration
may lead to a fine or seizure of the item and additional penalties. You may add a translation of the contents in a language
accepted in the destination country.
Your goods may be subject to restrictions. It is your responsibility to comply with import and export regulations and restrictions
(e.g., quarantine, pharmaceutical, etc.), and to determine what documents (e.g., commercial invoice, certificate of origin, health
certificate, license, authorization for goods subject to quarantine such as plant, animal, or food products, etc.), if any, are required
S A M P L E
in the destination country. Check the country listings at pe.usps.com/text/imm/immctry.htm, as well as the UPU List of Prohibited
Items available at www.upu.int/customs/en/country_list_en.pdf.
FROM (Sender information) and TO (Addressee information) sections: Enter both the sender’s and addressee’s full name and
full address in the blocks provided. Incomplete names (e.g., initials) or incomplete address entries may result in delayed handling
by Customs and/or the delivery office. Provide the telephone/fax number or email address of the sender, as such information will
facilitate customs clearance and delivery.
Block 1: Enter a detailed description of each article — e.g., “men’s cotton shirts.” General descriptions — e.g., “samples,” “food
products,” or “toiletries” — are not acceptable. If there is insufficient space on the form to list all articles, use additional forms as
needed. Indicate on the first form (to the right of the barcode) the following: “Additional forms enclosed.” Important: Obliterate the
tracking number and barcode on subsequent forms and place all the forms into PS Form 2976-E (plastic envelope).
Blocks 2–4: Enter the quantity, net weight (in pounds and ounces), and value (in U.S. dollars) of each article.
Block 5: Check the box specifying the category of the item. If the international shipment contains dangerous goods that are
approved for mailing, check the box for “Dangerous Goods.” Mailability information for international shipments is available in
Publication 52, Hazardous, Restricted, and Perishable Mail (chapter 6), and in International Mail Manual (IMM
) Part 135.
®
Block 6: Identify if special conditions or restrictions apply to items being mailed.
Block 7: Enter the total weight of the package in pounds and ounces, including packaging, which corresponds to the weight used
to calculate the postage.
Block 8: Enter the total value in U.S. dollars.
Block 9: Check the box specifying instructions in case of nondelivery. Items returned to the sender are subject to return charges
at the sender’s expense.
2976-A,
See reverse of this page for additional instructions on how to complete this form.
PS Form
July 2013 PSN 7530-01-000-9834
INSTRUCTIONS FOR COMPLETING THIS FORM (Remove this page prior to completing form.)
Please print this form in English using blue or black ink, pressing firmly so all information transfers to all copies. Complete the
declaration fully and legibly; otherwise, delay and inconvenience may result for the addressee. A false or misleading declaration
may lead to a fine or seizure of the item and additional penalties. You may add a translation of the contents in a language
accepted in the destination country.
Your goods may be subject to restrictions. It is your responsibility to comply with import and export regulations and restrictions
(e.g., quarantine, pharmaceutical, etc.), and to determine what documents (e.g., commercial invoice, certificate of origin, health
certificate, license, authorization for goods subject to quarantine such as plant, animal, or food products, etc.), if any, are required
S A M P L E
in the destination country. Check the country listings at pe.usps.com/text/imm/immctry.htm, as well as the UPU List of Prohibited
Items available at www.upu.int/customs/en/country_list_en.pdf.
FROM (Sender information) and TO (Addressee information) sections: Enter both the sender’s and addressee’s full name and
full address in the blocks provided. Incomplete names (e.g., initials) or incomplete address entries may result in delayed handling
by Customs and/or the delivery office. Provide the telephone/fax number or email address of the sender, as such information will
facilitate customs clearance and delivery.
Block 1: Enter a detailed description of each article — e.g., “men’s cotton shirts.” General descriptions — e.g., “samples,” “food
products,” or “toiletries” — are not acceptable. If there is insufficient space on the form to list all articles, use additional forms as
needed. Indicate on the first form (to the right of the barcode) the following: “Additional forms enclosed.” Important: Obliterate the
tracking number and barcode on subsequent forms and place all the forms into PS Form 2976-E (plastic envelope).
Blocks 2–4: Enter the quantity, net weight (in pounds and ounces), and value (in U.S. dollars) of each article.
Block 5: Check the box specifying the category of the item. If the international shipment contains dangerous goods that are
approved for mailing, check the box for “Dangerous Goods.” Mailability information for international shipments is available in
Publication 52, Hazardous, Restricted, and Perishable Mail (chapter 6), and in International Mail Manual (IMM
) Part 135.
®
Block 6: Identify if special conditions or restrictions apply to items being mailed.
Block 7: Enter the total weight of the package in pounds and ounces, including packaging, which corresponds to the weight used
to calculate the postage.
Block 8: Enter the total value in U.S. dollars.
Block 9: Check the box specifying instructions in case of nondelivery. Items returned to the sender are subject to return charges
at the sender’s expense.
2976-A,
See reverse of this page for additional instructions on how to complete this form.
PS Form
July 2013 PSN 7530-01-000-9834
Block 10: Except for shipments to APO/FPO/DPO addresses, enter an Automated Export System (AES) Internal Transaction
Number (ITN), AES Exemption, or if applicable, an AES Downtime Citation. This standard may also apply when mailing items to,
from, and between U.S. territories, possessions, and Freely Associated States — see DMM 608.2.5. One of these codes must
appear in the “AES/ITN/Exemption” block before the Postal Service will accept a package for mailing. In general, mailpieces
containing any type of goods (per Schedule B Export Codes at www.census.gov/foreign-trade/schedules/b) valued at more than
$2,500, or requiring an export license under U.S. law, must have an ITN issued by the U.S. Census Bureau or an AES Downtime
Citation, subject to certain exceptions. Mailpieces that are exempt from filing must have an AES Exemption. Regardless of
exemptions, all mailpieces must have an ITN or AES Downtime Citation if they are destined to certain countries on which the
U.S. has a comprehensive embargo. To obtain an ITN and file electronically through the Census Bureau’s AES, or for additional
information, please visit www.census.gov/foreign-trade/aes or call 800-549-0595. For additional information, refer to U.S. Postal
S A M P L E
Service
Publication 699, Special Requirements for Shipping Internationally, and to IMM Part 520.
®
AES Exemption. In order to comply with U.S. Census Bureau’s Foreign Trade Regulations, indicate “NOEEI § 30.37(a),” if
applicable. “NOEEI § 30.37(a)” may be used when the value of each class of goods is $2,500 or less, if an export license is not
required. Do NOT use this AES Exemption for items sent to Cuba, Iran, North Korea, Sudan, or Syria. Further information can be
found in IMM Parts 526 and 527.
Block 11: Check the box if the contents are subject to quarantine restrictions (plant, animal, food products, etc.).
Block 12:
Sign and date the form. Your signature certifies that all entries are correct and the item(s) being mailed contain no
undeclared dangerous, prohibited, or restricted contents per postal, customs, or destination country regulations. Your signature
also certifies compliance with all applicable federal export licensing and filing regulations and confirms your liability for the item(s)
being mailed.
Blocks 13–14: Enter Sender’s Customs Reference and Importer’s Reference, if applicable. (The Importer’s Reference might be a
tax code, importer code, or VAT number used for sales tax.)
Block 15: Enter, if known, the Importer’s telephone number, fax number, or email address, as such information might facilitate
customs clearance or delivery.
Blocks 16–20: In Blocks 16–18, enter License, Certificate, and/or Invoice number, if applicable. In Block 19, enter, if known,
the 6-digit Harmonized Tariff Schedule number, which is based on the Harmonized Commodity Description and Coding System
developed by the World Customs Organization. In Block 20, enter, if known, the “Country of Origin,” which is the country where
the goods originated — i.e., where they were produced/manufactured or assembled.
Insert the completed form(s) into PS Form 2976-E, Customs Declaration Envelope — CP 91. Enclose any commercial documents
in the envelope. Do not fold the form set or wrap it around the package. The entire barcode and all information must be visible.
Remove the backing sheet and affix the envelope to the package on the address side.
2976-A,
Reverse of instructions for completing form.
PS Form
July 2013 PSN 7530-01-000-9834
United States Postal Service
®
Customs Declaration and Dispatch Note — CP 72
IMPORTANT: This item may be opened officially. Please print in English, using blue or black ink, and press
firmly; you are making multiple copies. See Privacy Notice and Indemnity Coverage on Sender’s Copy.
FROM:
Sender’s Last Name
First
MI
Insured Amount (US $)
SDR Value
.
.
/
/
0
0
$
Business
Insurance Fees (US $) Total Postage/Fees (US $)
.
.
$
$
Address (Number, street, suite, apt., P.O. Box, etc. Residents of Puerto Rico include Urbanization Code preceeded with URB.)
13. Sender’s Customs Reference (If any)
City
State
ZIP+4
®
S A M P L E
14. Importer’s Reference - Optional (If any)
Telephone/Fax or Email
15. Importer’s Contact (select one)
Telephone Fax Email
TO:
Addressee’s Last Name
First
MI
Business
16. License No.
Address (Number, street, suite, apt., P.O. Box, etc.)
17. Certificate No.
Postcode
City
18. Invoice No.
State/Province
Country
For Commercial Senders Only
1. Detailed Description of Contents (enter one item per line)
2. Qty.
3. Lbs.
Oz.
4. Value (U.S. $)
19. HS Tariff Number
20. Country of Origin
.
of Goods
.
.
.
5. Check All That Apply:
6. Other Restrictions:
9. If non-deliverable:
Mailing Office Date Stamp
7. Total Gross
8. Total Value US $
Dangerous
(pertains to No. 11)
Gift
Returned Goods
Wt: (all items
(all items)
Treat as Abandoned
Goods
Lbs. & Ozs.)
Documents
Commercial Sample
.
.
Return to Sender
Merchandise
Humanitarian Donation
Other
Redirect to Address Below
10. AES/ITN/Exemption
11. Restrictions:
Quarantine
Sanitary or Phytosanitary Inspection
12. I certify the particulars given in this customs declaration are correct. This item does not contain any undeclared dangerous
articles, or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements
under federal law and regulations. Sender’s Signature and Date
Month Day
Year
2976-A,
PS Form
July 2013 PSN 7530-01-000-9834
Do not duplicate this form without USPS
®
approval.
1 – Customs Declaration
United States Postal Service
®
Customs Declaration and Dispatch Note — CP 72
IMPORTANT: This item may be opened officially. Please print in English, using blue or black ink, and press
firmly; you are making multiple copies. See Privacy Notice and Indemnity Coverage on Sender’s Copy.
FROM:
Sender’s Last Name
First
MI
Insured Amount (US $)
SDR Value
.
.
/
/
0
0
$
Business
Insurance Fees (US $) Total Postage/Fees (US $)
.
.
$
$
Address (Number, street, suite, apt., P.O. Box, etc. Residents of Puerto Rico include Urbanization Code preceeded with URB.)
13. Sender’s Customs Reference (If any)
City
State
ZIP+4
®
S A M P L E
14. Importer’s Reference - Optional (If any)
Telephone/Fax or Email
15. Importer’s Contact (select one)
Telephone Fax Email
TO:
Addressee’s Last Name
First
MI
Business
16. License No.
Address (Number, street, suite, apt., P.O. Box, etc.)
17. Certificate No.
Postcode
City
18. Invoice No.
State/Province
Country
For Commercial Senders Only
1. Detailed Description of Contents (enter one item per line)
2. Qty.
3. Lbs.
Oz.
4. Value (U.S. $)
19. HS Tariff Number
20. Country of Origin
.
of Goods
.
.
.
5. Check All That Apply:
6. Other Restrictions:
9. If non-deliverable:
Mailing Office Date Stamp
7. Total Gross
8. Total Value US $
Dangerous
(pertains to No. 11)
Gift
Returned Goods
Wt: (all items
(all items)
Treat as Abandoned
Goods
Lbs. & Ozs.)
Documents
Commercial Sample
.
.
Return to Sender
Merchandise
Humanitarian Donation
Other
Redirect to Address Below
10. AES/ITN/Exemption
11. Restrictions:
Quarantine
Sanitary or Phytosanitary Inspection
12. I certify the particulars given in this customs declaration are correct. This item does not contain any undeclared dangerous
articles, or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements
under federal law and regulations. Sender’s Signature and Date
Month Day
Year
2976-A,
PS Form
July 2013 PSN 7530-01-000-9834
Do not duplicate this form without USPS
®
approval.
2 – Customs Declaration
United States Postal Service
®
Customs Declaration and Dispatch Note — CP 72
IMPORTANT: This item may be opened officially. Please print in English, using blue or black ink, and press
firmly; you are making multiple copies. See Privacy Notice and Indemnity Coverage on Sender’s Copy.
FROM:
Sender’s Last Name
First
MI
Insured Amount (US $)
SDR Value
.
.
/
/
0
0
$
Business
Insurance Fees (US $) Total Postage/Fees (US $)
.
.
$
$
Address (Number, street, suite, apt., P.O. Box, etc. Residents of Puerto Rico include Urbanization Code preceeded with URB.)
13. Sender’s Customs Reference (If any)
City
State
ZIP+4
®
S A M P L E
14. Importer’s Reference - Optional (If any)
Telephone/Fax or Email
15. Importer’s Contact (select one)
Telephone Fax Email
TO:
Addressee’s Last Name
First
MI
Business
Declaration by ADDRESSEE: I have received the parcel
described on this note. ADDRESSEE’S Signature and Date
Month Day
Year
Address (Number, street, suite, apt., P.O. Box, etc.)
Postcode
City
18. Invoice No.
State/Province
Country
Please affix labels here when required.
Office of Exchange
Customs Stamp
Customs Duty
5. Check All That Apply:
6. Other Restrictions:
9. If non-deliverable:
Mailing Office Date Stamp
7. Total Gross
8. Total Value US $
Dangerous
(pertains to No. 11)
Gift
Returned Goods
Wt: (all items
(all items)
Treat as Abandoned
Goods
Lbs. & Ozs.)
.
.
Documents
Commercial Sample
Return to Sender
Merchandise
Humanitarian Donation
Other
Redirect to Address Below
10. AES/ITN/Exemption
11. Restrictions:
Quarantine
Sanitary or Phytosanitary Inspection
12. I certify the particulars given in this customs declaration are correct. This item does not contain any undeclared dangerous
articles, or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements
under federal law and regulations. Sender’s Signature and Date
Month Day
Year
2976-A,
PS Form
July 2013 PSN 7530-01-000-9834
Do not duplicate this form without USPS
®
approval.
3 – Dispatch Note
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