Fcc Form 740 Fillable – Fill Out and Use This PDF

FEDERAL COMMUNCATIONS COMMISSION	Approved by OMB
Washington, D.C. 20554	3060-0059

STATE ME NT RE GARDING THE IMPORTATION OF RADIO FRE QUE NCY DE VICE S CAPABLE OF

CAUSING HARMFUL INTE RFE RE NCE

(Read instructions before completing form. Please type or print clearly in ink .)

Part I - All Blocks MUST Be Completed
Date of E ntry	E ntry Number	Port of E ntry1		Harmonized Tariff Number2	Quantity of Item (not number of containers)3
Device Model/Type Name or #		Trade Name		FCC ID	Description of E quipment
Manufacturer’s Name and Address			Consignee’s Name and Address		Importer’s Name and Address

Printed or Typed Name of Importer or Consignee

Signature of Importer or Consignee

Date (Month/Day/Year)

Warning: Any person who knowingly makes a false declaration may be fined not more than $250,000 or imprisoned not more than 5 years, or both, pursuant to 18 U.S.C. § 1001.

Part II - With Regard to the Importation of the Described Radio Frequency Device(s), I DE CLARE THAT:

(Place an “X” in only one box)

1.The FCC has issued a grant of equipment authorization for the FCC ID listed above.

2.An FCC grant of equipment authorization and an FCC ID are not required, but the equipment complies with FCC technical requirements.

3.The described equipment is being imported in limited quantities for testing and evaluation for compliance with technical requirements or marketing suitability. The equipment will not be offered for sale or otherwise marketed. (See Instructions)

4.The described equipment is being imported in limited quantities for demonstration at industry trade shows and will not be offered for sale or otherwise marketed. (See Instructions)

5.The described equipment is being imported solely for export. It will not be offered for sale or otherwise marketed in the U.S. 5(a). The described equipment is a non-U.S. standard cellular phone that can only function outside of the U.S. (See Instructions)

6.The described equipment is being imported for use exclusively by the U.S. G overnment.

7.Three or fewer radio receivers, computers, or other unintentional radiators as defined in Part 15 of the FCC Rules, are being imported for an individual’s personal use and are not intended for sale.

8.The described equipment is being imported for repair and will not be offered for sale or otherwise marketed.

1.Port of E ntry Use Schedule D – Classification of U.S. Customs Districts and Ports for U.S. Foreign Trade Statistics – a four digit code i.e., New York City, NY 1001.

2.Harmonized Tariff Number – Harmonized Tariff Schedule of the United States.

3.This quantity must be total number of items, not number of containers.

FCC Form 740

March 2004

INSTRUCTIONS F OR COMPLE TION OF F CC F ORM 740

This form must be completed for each radio frequency device, as defined in 47 U.S.C. 302 and 47 C.F .R. 2.801, which is imported into the Customs territory of the United States. The original shall be filed with the U.S Customs Service on or before the date the shipment is delivered to a U.S. port of entry.

The completed form must accompany each such entry.

The following are typical examples of devices that require the use of FCC Form 740: radio and TV receivers, converters, transmitters, transmitting devices, radio frequency amplifiers, microwave ovens, industrial heaters, ultrasonic equipment, transceivers, and computers.

Marketing, as used in this form (and 47 C.F .R. 2.1201 et seq.), means sale or lease (including advertising for sale or lease, or display at a trade show) or import, ship or distribute for the purpose of selling or leasing or offering for sale or lease.

Limited quantities, as used in this form, are the number specified in 47 C.F .R. 2.1204(a)(3). Waivers of this limit are infrequently granted but may be requested from the FCC office listed in 47 C.F .R. 2.1204(a)(3)(iii). Written waiver requests must contain specific information required by that office.

E quipment imported for test, evaluation or display (see import conditions 3 or 4 of Part II of this form) may not be marketed (sold or leased, offered for sale or lease, advertised, etc.). Display of this equipment must include markings clearly indicating that the device(s) are not eligible for sale. See 47 C.F .R. 2.803 for details regarding this labeling.

Wireless telephony devices that do not have a FCC grant of equipment authorization must either comply with 47 C.F .R. 2.1204(a)(5) or 47 C.F.R. 2.803(a)(2) (e.g., Verification or Declaration of Conformity is required).

The identification (company name and model number/FCC ID) of the radio frequency device specified on the front of this form must be identical to the company name and model number/FCC ID inscribed on the device. If the device being imported requires an equipment authorization to be issued by the FCC (e.g., Certification), it is important that the name of the company, description of the device and FCC ID specified on the grant of equipment authorization agree exactly with the same information shown on the front of this form. Any discrepancy between the information on this form and the FCC grant of equipment authorization may result in unnecessary delays, additional expense, or enforcement action.

F CC F orm 740 may be reproduced provided the following conditions are met (see 47 C.F .R. 0.409, Commission Policy on

Private Printing of F CC F orms.) Some of the conditions are listed below:

1.That private companies reproducing the form use a printing process resulting in a product that is comparable to the original document;

2.That private companies reproducing the form refrain from including therein or attaching thereto any advertising matter or deleting any material from the form;

3.That private companies reproducing the form exercise care that the form being reproduced or distributed is the current edition presently used by the FCC for the type of application involved: such private company to be advised that, though the Commission will endeavor to keep the public advised of revisions of the form, it cannot assume responsibility to the extent of eliminating any element or risk against overstocking, etc.

PAPE RWORK RE DUCTION ACT STATE ME NT AND PRIVACY ACT STATE ME NT

The solicitation of information requested on this form is authorized by the Communications Act of 1934, as amended. The information collected will be used to ascertain whether equipment authorization is required, and if so, whether or not it has been granted. If all the information is not provided the importation of this or other shipments may be delayed or prevented. Accordingly, every effort should be made to provide all necessary information. Your response is required to obtain a benefit.

Public reporting for this collection of information is estimated to average .04 seconds 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. Comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, should be sent to the Federal Communications Commission, Performance and E valuations and Records Management, Washington, DC 20554, Paperwork Reduction Project (3060-0059) DO NOT SE ND COMPLE TE D FORMS TO THIS ADDRE SS. Individuals are not required to respond to a collection of information unless it displays a currently valid OMB control number.

TH E F ORE GOING NOTICE IS RE QUIRE D BY TH E PRIVACY ACT OF 1974, P.L . 93-579, DE CE MBE R 31, 1974, 5 U.S.C. 552A(E )(3), AND TH E PAPE RWORK RE DUCTION ACT OF 1995, P.L . 104-13, OCTOBE R 1, 1995, 44 U.S.C. 3507.

FCC Form 740 instructions – Page 2

March 2004