PS Form 2976 Customs Declaration Cn 22 - Sender's Declaration - Sample

What Is PS Form 2976?

PS Form 2976, Customs Declaration CN 22 - Sender's Declaration (also known as the USPS Form 2976) is a customs form used by the United States Postal Service (USPS) for a detailed description of your packet contents. This information is used by the border control agency to determine duty fees and tariffs on incoming goods.

The latest version of the declaration was released by the USPS in July 2013 with previous editions still used. A sample printable version of the PS Form 2976 is available below for reference or can be found through the USPS forms website.

The PS Form 2976 is used for small packages (packets) sent via First-Class Mail International; for First-Class Package International Service items; M-bags and certain Priority Mail Express International items. This form should be used for First-Class Mail International mailpiece and Priority Mail International Flat Rate Envelopes, if the package weighs 16 ounces or more, exceeds 3/4 inch in thickness or contains dutiable goods. It is also used for packages sent to Military Mail within the U.S. Territories by Priority Mail International service.

Do not use this form if the package contains items valued more than $400, requires an export license, contains goods or destined for Iran, Sudan, Syria, Cuba or North Korea. A customs form is not needed if the package contains only non-negotiable documents or correspondence, weighs under 16 ounces and is sent by First-Class Mail International service.

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Customs Declaration CN 22 – Sender’s Declaration
Instructions for Completing Customs Declaration
Please retain this copy and the detached customer copy
from page 2 for your records. You will need the information
contained on these pages if you contact us about the
article(s) you mailed.
A PS Form 2976, Customs Declaration CN22 – Sender’s Declaration, must be used on all First-Class Mail International
package-
®
size items (small packets), First-Class Package International Service
items, Priority Mail International
Small Flat Rate Boxes,
®
M-bags, and certain Priority Mail Express International
items. Refer to the International Mail Manual (IMM
) at pe.usps.com for
®
additional information.
S A M P L E
Also use this form on a First-Class Mail International mailpiece or Priority Mail International Flat Rate Envelopes if ANY of the
following applies:
The mailpiece weighs 16 ounces or more (the maximum weight limit is 4 pounds);
J
The mailpiece exceeds 3/4 inch in thickness; or
J
The mailpiece contains dutiable goods.
J
NOTE: Priority Mail International Flat Rate Envelopes and First-Class Mail International large envelopes (flats) containing only
documents, weighing under 16 ounces, and meeting the flat-size characteristics do not require a PS Form 2976.
Do not use this form for mailpieces that: (1) Contain items valued over $400; (2) Require an export license; (3) Contain goods
(non-documents) destined to Iran, Sudan, or Syria; or (4) Contain goods destined to Cuba or North Korea, other than gift parcels or
humanitarian donations as defined by 15 CFR § 740.12.
For APO, FPO and DPO destinations, use PS Form 2976 when sending certain items (all domestic mail classes). Refer to the
current “Overseas Military/Diplomatic Mail” section of the latest Postal Bulletin at usps.com for additional information.
Regardless of value and weight, mail sent to, from, and between U.S. possessions and territories, Freely Associated States, and
APO/FPO/DPO addresses may require a customs form. Refer to Domestic Mail Manual Section 608.2.4 for additional information.
Goods may be subject to restrictions. It is the responsibility of the mailer to inquire about and abide by any import and export
regulations and restrictions (e.g., quarantine, pharmaceutical, etc.), and to properly complete this form.
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. Please provide the telephone/fax number or email address of both the sender and addressee, as
such information will facilitate customs clearance and delivery.
PS Form 2976, July 2013
Sender’s Instructions
Additional instructions and Privacy Statement continued on reverse of this page.
Customs Declaration CN 22 – Sender’s Declaration
Instructions for Completing Customs Declaration
Please retain this copy and the detached customer copy
from page 2 for your records. You will need the information
contained on these pages if you contact us about the
article(s) you mailed.
A PS Form 2976, Customs Declaration CN22 – Sender’s Declaration, must be used on all First-Class Mail International
package-
®
size items (small packets), First-Class Package International Service
items, Priority Mail International
Small Flat Rate Boxes,
®
M-bags, and certain Priority Mail Express International
items. Refer to the International Mail Manual (IMM
) at pe.usps.com for
®
additional information.
S A M P L E
Also use this form on a First-Class Mail International mailpiece or Priority Mail International Flat Rate Envelopes if ANY of the
following applies:
The mailpiece weighs 16 ounces or more (the maximum weight limit is 4 pounds);
J
The mailpiece exceeds 3/4 inch in thickness; or
J
The mailpiece contains dutiable goods.
J
NOTE: Priority Mail International Flat Rate Envelopes and First-Class Mail International large envelopes (flats) containing only
documents, weighing under 16 ounces, and meeting the flat-size characteristics do not require a PS Form 2976.
Do not use this form for mailpieces that: (1) Contain items valued over $400; (2) Require an export license; (3) Contain goods
(non-documents) destined to Iran, Sudan, or Syria; or (4) Contain goods destined to Cuba or North Korea, other than gift parcels or
humanitarian donations as defined by 15 CFR § 740.12.
For APO, FPO and DPO destinations, use PS Form 2976 when sending certain items (all domestic mail classes). Refer to the
current “Overseas Military/Diplomatic Mail” section of the latest Postal Bulletin at usps.com for additional information.
Regardless of value and weight, mail sent to, from, and between U.S. possessions and territories, Freely Associated States, and
APO/FPO/DPO addresses may require a customs form. Refer to Domestic Mail Manual Section 608.2.4 for additional information.
Goods may be subject to restrictions. It is the responsibility of the mailer to inquire about and abide by any import and export
regulations and restrictions (e.g., quarantine, pharmaceutical, etc.), and to properly complete this form.
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. Please provide the telephone/fax number or email address of both the sender and addressee, as
such information will facilitate customs clearance and delivery.
PS Form 2976, July 2013
Sender’s Instructions
Additional instructions and Privacy Statement continued on reverse of this page.
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 IMM Part 135.
(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. (2), (3), and (4) Enter the quantity, net weight (pounds and ounces), and value of each article.
(5) For commercial items only. 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. (6) Enter, if known, the “Country of
Origin,” which is the country where the goods originated — i.e., where they were produced/manufactured or assembled. (7) Enter
the total quantity, weight, and value of all articles.
(8) AES Exemption. In order to comply with the U.S. Census Bureau’s Foreign Trade Regulations, check the box
S A M P L E
“NOEEI § 30.37(a)” or “NOEEI § 30.37(h).” Further information is available in IMM Parts 526 and 527. Use the following
explanations to help determine your choice:
NOEEI § 30.37(a): Use this AES Exemption when the value of each class of goods is $2,500 or less, if an export license is
J
not required. Do NOT use this AES Exemption for items sent to Cuba or North Korea.
NOEEI § 30.37(h): Use this AES Exemption for gift parcels or humanitarian donations destined to certain sanctioned
J
countries (as of July 2013, this includes Cuba and North Korea), if the package complies with the conditions set forth in
15 CFR § 740.12.
(9) 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.
Privacy Act Statement: Your information will be used to satisfy reporting requirements for customs purposes. Collection is
authorized by 39 U.S.C. 401, 403, 404, and 407; 13 U.S.C. 301–307; and 50 U.S.C. 1702. Providing the information is voluntary,
but if not provided, we may not process your transaction. We do not disclose your information to third parties without your
consent, except to facilitate the transaction, to act on your behalf or request, or as legally required. This includes the following
limited circumstances: to a congressional office on your behalf; to financial entities regarding financial transaction issues; to a
U.S. Postal Service auditor; to entities, including law enforcement, as required by law or in legal proceedings; to contractors and
other entities aiding us to fulfill the service (service providers); to domestic and international customs pursuant to federal law
and agreements; and to other governmental entities with authority over exportation. For more information regarding our privacy
policies, visit usps.com/privacypolicy.
PS Form 2976, July 2013
Reverse — Sender’s Instructions
Do not duplicate without USPS approval.
USPS
®
Customs Declaration – CN 22
IMPORTANT: The item/parcel may be opened officially. See
Privacy Notice on reverse of Sender’s Instructions page. Please
print in English and press firmly; you are making multiple copies.
Sender’s Last Name
First
Business
Documents
Commercial sample
Merchandise
Dangerous Goods
Other
Gift
Humanitarian Donation
Address
Qty.
Value (4)
Weight (3)
HS Tariff
Country of
S A M P L E
Detailed description of contents (1)
Origin (6)
lb.
oz.
(US $)
# (5)
(2)
City
State
ZIP+4
®
Telephone/Fax or Email
Addressee’s Last Name
First
Totals (7)
Business
$
Mailing Office Date Stamp
AES Exemption (8)
NOEEI § 30.37(a)
NOEEI § 30.37(h)
Address
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
City
State/Province
Post Code
customs regulations. I have met all applicable export filing
requirements under federal law and regulations.
Sender’s Signature and Date (9)
Country
Telephone/Fax or Email
PS Form 2976, July 2013
1 - Post Office Copy — retain on file for 30 days after mailing
PSN 7530-01-000-9833
USPS
®
Customs Declaration – CN 22
IMPORTANT: The item/parcel may be opened officially. See
Privacy Notice on reverse of Sender’s Instructions page. Please
print in English and press firmly; you are making multiple copies.
Sender’s Last Name
First
Business
Documents
Commercial sample
Merchandise
Dangerous Goods
Other
Gift
Humanitarian Donation
Address
Qty.
Value (4)
Weight (3)
HS Tariff
Country of
S A M P L E
Detailed description of contents (1)
Origin (6)
lb.
oz.
(US $)
# (5)
(2)
City
State
ZIP+4
®
Telephone/Fax or Email
Addressee’s Last Name
First
Totals (7)
Business
$
Mailing Office Date Stamp
AES Exemption (8)
NOEEI § 30.37(a)
NOEEI § 30.37(h)
Address
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
City
State/Province
Post Code
customs regulations. I have met all applicable export filing
requirements under federal law and regulations.
Sender’s Signature and Date (9)
Country
Telephone/Fax or Email
2 - Shipping Label (left) and Customer Copy (right)
PS Form 2976, July 2013
PSN 7530-01-000-9833

Download PS Form 2976 Customs Declaration Cn 22 - Sender's Declaration - Sample

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What to Write on PS Form 2976?

  1. Provide your name and address, as well as the full name and the address of the addressee. Provide your and the addressee's telephone or fax number, and/or email address in order to facilitate customs clearance and delivery.
  2. Indicate the type of items: documents, commercial samples, dangerous goods, merchandise, humanitarian donations, or gifts.
  3. Describe every item in the package: the name of the item (be specific), quantity, net weight in pounds and ounces, and value. Enter the country of origin of every item, if it is known.
  4. If your package contains commercial items, provide the 6-digit Harmonized Tariff Schedule number.
  5. Provide the total quantity, weight, and value of all articles.
  6. In the next block, the sender has to choose the AES Exemption. If the value of each type of goods is $2,500 or less and the export license is not required, the J NOEEI § 30.37(a) option should be used. If the parcel is a gift or humanitarian donation to Cuba, the J NOEEI § 30.37(h) is necessary.
  7. Sign and date the form.

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

The PS Form 2976-A, Customs Declaration and Dispatch Note CP 72 (Reference Only), is used for a similar purpose as the PS 2976. However, the USPS Form 2976-A is used for all Priority Mail International shipments, except military mail ones.

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

How to Order PS Form 2976?

There are several ways to obtain the PS form 2976.

The form can be filled online using the Click-N-Ship tool at the USPS website. The website will automatically choose the appropriate form. The Click-N-Ship will also prepare a shipping label for packages sent by the Priority Mail Express International, Priority Mail International or First-Class Package International Service.

The completed form can be printed out. Alternatively, if you are using an international service that doesn't give you such an option, you can create and fill out a necessary form at the same webpage.

A customs form can be obtained and filled out at the local post office. The Postal Service employee can provide assistance in completing the customs form.

How Many Copies of PS Form 2976 Do I Need to Put on the Package?

The PS Form 2976 should be printed in three copies. One copy is placed in the package, another one is for the sender and the third one is kept at the post office for 30 days. Make sure you retain a copy of the form for all possible inquiries regarding your package.

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