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- 1. The goods (except for textiles and textile articles of Chapter 50 through 63) described in field 2 below arrived at this premise from:
- Company Name
- Company Address
- Invoice number
- Invoice date (DD-MM-YY)
- 2. Description of Goods imported into United States.
- For goods listed in Field No. 2, did your company perform minor processing (see reverse for definition) or any processing that did not increase the transaction value of the goods by greater than ten per cent?
- YES, go to Field Nos. 4, 5 and 6.
- NO, go to Field Nos. 3, 5 and 6
- 3. I certify that the goods listed above in field 2, after being released from customs control in the United States, have not undergone any processing other than storage or shipment.
- 4. The minor processing or the processing (that did not increase the transaction value of the goods by greater than ten per cent) that has been carried out on the goods listed in field 2 is as follows. Fully describe the processing carried out:
- 5. Description of Goods exported from the United States
- 6. I CERTIFY that:
- the information on this document is true and accurate and I assume the responsibility for proving such representations. I understand that I am liable for any false statements or material omissions made on or in connection with this document;
- I agree to maintain for not less than 5 years, and present upon request, documentation necessary to support this Declaration, and to inform, in writing, all persons to whom the Declaration was given of any changes that would affect the accuracy of this Declaration;
- I agree to plant visits; and
- this Declaration consists of (number) page(s), including all attachments.
- Authorized signature
- Company Name
- Date (DD-MM-YY)
Instructions and definitions
In order for Canadian/Israeli importers to claim preferential tariff treatment under CIFTA this form is required to be completed by US exporters under certain circumstances as listed below. Please note that the company name and address in Field 1 is the company name and address of the Canadian/Israeli exporter in Canada/Israel. Additional information to this form may also be required.
Complete this form if:
- 1. qualifying goods entered the commerce of the United States (see definition below) or are otherwise not subject to a through bill of lading from Israel to Canada or from Canada to Israel (see box 3)
- 2. minor processing is performed on qualifying goods in the United States (see box 4)
- 3. any processing is performed in the United States on qualifying goods that does not increase the transaction value of these goods by greater than ten per cent (see box 4)
DO NOT complete this form if:
- 1. the goods are textiles and textile articles of Chapter 50 through 63
- 2. the goods are passing through the United States to Canada/Israel on a through bill of lading
- 3. more than minor processing occurs in the United States, (in such cases, the goods will not qualify for the benefits of CIFTA)
- 4. the goods were subject to any processing that increased their transaction value by greater than ten per cent.
- means a modification, other than a repair, that does not include an operation or process that either destroys the essential characteristics of a good or creates a new or commercially different good;
- description of goods:
- include such information as the HS classification number to six or eight digits, quantity, value, weight, marks and numbers;
- minor processing
- (a) mere dilution with water or any other substance that does not materially alter the characteristics of the good,
- (b) cleaning, including removal of rust, grease, paint or any other coating,
- (c) applying any preservative or decorative coating, including any lubricant, protective encapsulation, preservative or decorative paint, or metallic coating,
- (d) trimming, filing or cutting off small amounts of excess material,
- (e) packing or repacking of the good for transport, storage or sale,
- (f) packaging or repackaging of the good for retail sale or relabelling of the good in one or more official languages of a Party, or
- (g) repairs or alterations, washing, laundering or sterilizing;
- means the adjustment of a machine, instrument, electrical device or other article, including replacing or refitting parts to restore the article to its original operating condition;
- United States
- (i) the customs territory of the United States, which includes the 50 states, the District of Columbia and Puerto Rico,
- (ii) the foreign trade zones located in the United States and Puerto Rico, and
- (iii) any areas beyond the territorial seas of the United States within which, in accordance with international law and its domestic law, the United States may exercise rights with respect to the seabed and subsoil and their natural resources.
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