EXPORTER'S
STATEMENT OF ORIGIN:

I certify that the goods described in this invoice

or in the attached invoice # ______________________

were produced in the beneficiary country of

________________________________________

and that at least _______percent

of the ex-factory price of these goods

originates in the country/countries of

_________________________________
(Name of Country or Countries)

___________________________________________________
(Corporation Name)

___________________________________________________
(Street Address)

___________________________________________________
(City, Country, Postal Code)

___________________________________________________
(Telephone Number)

___________________________________________________
(Fax Number)

___________________________________________________
(Signature)

___________________________________________________
(Name and Title)

___________________________________________________
(Date)

Source: www.customsbrokers.ca
(Certificates of Origin / Exporter's Statement of Origin)

---

(BACK TO CUSTOMS BROKERS CANADA
CERTIFICATES OF ORIGIN PAGE) 

---

Last updated 2000-06-11