U.s. Customs Invoice Template
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1U.S. Customs Invoice
Exporter
Purchaser
(If Other than Ultimate Consignee)
Tel:
Contact
Purchaser IRS Number.
Ultimate Consignee
Carrier Pro Number
Other References (include Purchase Order #)
Ultimate Consignee IRS Number:
Bill Customs Charges To
Country of Manufacture
Destination (Country/State)
Shipper
(if other)
/ U.S.A.
Exporting Carrier
Terms of Sale
Port of Entry
Parties to This Transaction Related Yes
No
Gross Weight
Currency of Sale
KG
LB
U.S.$.
Canadian $
Other
Is Duty Included in Invoice Yes
No X
Is Freight Included in Invoice Yes
No X
# of
Country
Description
HSCode
Qty
Unit Price
Total
Pkgs
of Origin
$
THIS INVOICE IS FOR CUSTOMS
PURPOSES ONLY.
Total
$
Other Additions
Estimated Freight Charges
To Point of Exit
Or To Destination
Other Deductions
NAFTA CLAIMED
TOTAL
: CERTIFICATE ATTACHED
OR
UNDER $1250.00 – I CERTIFY THE ABOVE GOODS QUALIFY UNDER THE NAFTA REGULATIONS
$
INVOICE
Signature
Capacity
Declaration By Foreign Shipper (Complete if Goods Described Below are of U.S. Origin and Value Exceeds $1000.00) I,
Declare that to the
best of my knowledge and belief the articles herein specified are products of the United 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 value or improved in
condition by any process of manufacture of other means
Signature
Capacity
I HEREBY CERTIFY THAT THE INFORMATION GIVEN ABOVE AND ON THE CONTINUATION SHEET (S), IF ANY, IS TRUE AND COMPLETE IN
EVERY RESPECT
Date of Direct Shipment 07/23/15
Signature:
Status Owner X
Agent
PO Box 370
Phone: 877-332-4552
Blaine, WA 98231
Fax:
877-332-8717
Email Address:
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