Invoice Template For U.s. Customs Clearance By Customs Broker
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INVOICE
1. EXPORTER, SHIPPER, SELLER AND MAILING ADDRESS
8. SHIPPER’S REF. NO.
FOR U.S. CUSTOMS CLEARANCE BY
CUSTOMS BROKER:
9. PAGE
OF
2. CONSiGNEE AND MAILING ADDRESS
3. IRS NO.
4. BUYER (IF OTHER THAN CONSIGNEE)
10. US DUTY AND/OR BROKERAGE FOR:
SHIPPER
SHIPPER
(INCLUDED)
(NOT INCLUDED)
BUYER
CONSIGNEE
5. IRS NO.
6. CONSIGNEE’S OR BUYER’S REF. NO.
11. PARTIES TO THIS TRANSACTION ARE:
12. EXCHANGE RATE
RELATED
NOT RELATED
7. TERMS OF SALE-DELIVERY-PAYMENT
13. EXPORTING CARRIER
14 CURRENCY OF VALUE
15. FREIGHT CHARGES
FOB PLANT
C&F/CIF DESTINATION
PREPAID
PREPAID
COLLECT
(INCLUDED)
(NOT INCLUDED)
OTHER (IDENTIFY)
_________________________________________
TO POINT OF EXIT $
OR TO DESTINATION $
16. MARKS AND NUMBERS
17.
COUNTRY/
18. #
19. DESCRIPTION OF GOODS (INCLUDE H.S. NUMBER, IF KNOWN)
20. WEIGHT
21. QUANTITY
22. UNIT PRICE
23. TOTAL PRICE
PROVINCE OF
OF
ORIGIN
PKGS
24. INVOICE TOTAL
25. DECLARATION BY FOREIGN SHIPPER
26. I HEREBY CERTIFY THAT THE INFORMATION GIVEN ABOVE AND ON THE
*
(TO BE COMPLETED ONLY WHEN THE GOODS DESCRIBED ABOVE ARE OF U.S. MANUFACTURE OR
CONTINUATION SHEET (S), IF ANY, IS TRUE AND COMPLETE IN EVERY RESPECT.
GROWTH).
, DECLARE THAT THE ARTICLES HEREIN SPECIFIED ARE, TO THE
BEST OF MY KNOWLEDGE AND BELIEF, THE GROWTH PRODUCE OR MANUFACTURE OF THE UNITED
NAME OF RESPONSIBLE EMPLOYEE OF EXPORTER
STATES, THAT THEY WERE EXPORTED FROM THE UNITED STATES FROM THE PORT OF
ON OR ABOUT
THAT THEY ARE RETURNED WITHOUT HAVING BEEN ADVANCED
IN VALUE OR IMPROVED IN CONDITION BY ANY PROCESS OF MANUFACTURE OR OTHER MEANS.
GIVE FIRM NAME AND ADDRESS IF DIFFERENT FROM EXPORTER BOX ABOVE
DATE _____________________________________
STATUS
SIGNATURE
STATUS
SIGNATURE ________________________________
OWNER
AGENT
MANITOULIN TRANSPORT INC.
SEE REVERSE FOR INSTRUCTIONS
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