CBP Form 3495 at a glance
What it is: CBP Form 3495 is the Application for Exportation of Articles Under Special Bond, 19 CFR 10.38, of U.S. Customs and Border Protection.
Who signs: SIGN: Signature of Importer or Agent, and Date.
What to bring and attach to CBP Form 3495
Please attach copy of export invoice describing articles to be exported.
A filled-in CBP Form 3495 example: an importer applies to export examined goods
How to fill out CBP Form 3495, box by box
Importer/Agent Export Information: To and From
Under FROM: (Importer or Agent), enter the Name (Last, First, MI), Street Address Line 1, Street Address Line 2, City, State and Zip Code.
Under TO: CBP Port Director (Email and Address), enter the Street Address Line 1, Street Address Line 2, City, State, Zip Code and Port Email.
Exporting carrier, departure, origin, packages and entry
Enter the Name of Exporting Carrier.
Enter the Date of Departure, Country of Origin and No. of Export Packages.
Enter the Port of Entry.
Enter the Entry Number, Date and Date Bonded Period Expires.
Date articles available and signature
Enter the Date Articles Available for CBP Examination.
SIGN: Signature of Importer or Agent, and Date.
More rules for CBP Form 3495
FOR CBP USE ONLY: NOTICE TO IMPORTER TO DELIVER ARTICLES TO BE EXAMINED AND IDENTIFIED FOR EXPORTATION.
If your situation is different
Who submits the form and when
INSTRUCTIONS: The CBP Form 3495, Application for Exportation of Articles Under Special Bond, will only be required when merchandise has been designated for examination. In those instances in which an export examination has been designated, the importer/broker is required to submit the form prior to exportation to the Port Director or his/her designee. It shall be the responsibility of the importer of record to ensure the CBP Form 3495 is presented to the port of exportation in sufficient time to perform the examination. The Port Director at the port of exportation will determine the time frame for presentation of the form prior to exportation.
Sources
[1] CBP Form 3495 (06/25), Application for Exportation of Articles Under Special Bond, U.S. Customs and Border Protection (the Official source link on this page).