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Imported Material Report

California regulations require any person importing empty beverage container materials greater than 25 pounds of aluminum, bimetal or plastic, or more than 250 pounds of glass to provide a fully completed and signed Imported Material Report (IMB), and all applicable required supporting documentation, to California Department of Food and Agriculture (CDFA) personnel upon seeking entry into California. More information is available on the Imported Empty Beverage Container Reporting and Inspection Program page.

You have errors on your form!

A. POINT OF ORIGIN

Address: *

City: *

State: *

B. DESTINATION

Type of destination the material will be delivered to: *

Other: *

CA Program ID [PR RC CS CP SP]:

Destination Street Address: *

City: *

State: *

ZIP code: *

Phone: *

C. MATERIAL

Does the material contain imported empty beverage containers
Yes No

Will the material be sold in California for scrap value?
Yes No

Will the material be sold in CA for CA Refund Value (CRV)?
Yes No

Weight of Material: *

Estimate the percentage of declared material that is empty beverage containers: *

How was the reported weight determined: *

Other: *

Material Type: *

Form of Material: *

D. VEHICLE

Type of vehicle / vessel used to transport the material:

Trailer (towed by 2 axle vehicle)

Vehicle License Number:

Trailer License Number:

VL State:

TL State:

Vehicle Year:

Shipping Container Number:

Vehicle Make:

Vehicle Model:

E. RENTAL TRUCK

Rental Truck Company Name:

Other Rental Company Name:

Rental Company Address:

City:

State:

ZIP code:

Phone:

First Name on Rental Contract:

Last Name on Rental Contract:

Rental Contract Number:

Rental Vehicle Tracking Number:

F. CARRIER

The owner / lease holder / renter of the vehicle is:

U.S. DOT Number:

Business Name:

MCP - CA Motor Carrier Permit Number:

First Name:

Last Name:

Address:

City:

State:

ZIP code:

Phone:

G. SHIPPER / CONSIGNOR

Title / Company Name:

First Name:

Last Name:

Address:

City:

State:

ZIP code:

Phone:

H. PREPARED BY

Title / Company Name:

First Name: *

Last Name: *

Address: *

City: *

State: *

ZIP code: *

Phone: *

Signature Date:

Not a U.S. Phone Number

I. DRIVER

The driver of the vehicle is:

First Name:

Last Name:

Driver's License Number:

DL State:

J. RECEIVER

Job Title:

First Name:

Last Name:

Address:

City:

State:

ZIP code:

Phone:

Imported Empty Beverage Container Reporting & Inspection Program https://www2.calrecycle.ca.gov/BevContainerImports/
Contact: Investigations@Calrecycle.ca.gov 1-866-CANLOAD
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