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DE CLAR ATION FOR IMPOR TE D E LE CTR ONIC PR ODUCTS …

F orm A pproved OMB No. 0910-0025. DE P A R T ME NT OF HE A L T H A ND HUMA N S E R V IC E S E xpiration Date: 11/30/2003. P UB L IC HE A L T H S E R V IC E. INS T R UC T IONS. F OOD A ND DR UG A DMINIS T R A T ION. 1. If s ubmittingentries elec tronic allythroughA C S /A B I, hold F DA -2877 in entry file. Do not s ubmitto F DA unles s reques ted. DE C L A R A T ION F OR IMP OR T E D 2. If s ubmittingpaper entry doc uments ,s ubmitthe followingto F DA : a. 2 c opies of C us toms E ntry F orm ( C F 3461, C F 3461 A lt, E L E C T R ONIC P R ODUC T S S UB J E C T T O C F 7501, etc.)

for m fda 2877 (12/00) pr e vious e dition is ob s ole te . created by: ps c media arts (301) 443-2454 e f d. do not comply with pe r for mance s tandar ds ; ar e he ld and will r e main unde r b ond; and will not b e

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