UNITED STATES MEXICO CANADA AGREEMENT (USMCA)

CERTIFICATION OF ORIGIN



Blanket Date



From:      
To:      


Certifier



Name: Address:
E-Mail: Tax Identification #:


Exporter

Name: Address:
E-Mail: Phone:
Tax Identification #:


Producer

Name: Address:
E-Mail: Phone:
Tax Identification #:


Importer

Name: Address:
E-Mail: Phone:
Tax Identification #:


Goods


Description of Goods HTS Origin Criterion Certification Indicator Method of Qualification Country of Origin


Aknowledgement



Name: Title:
Company: Date:      
Phone #: Email: