K36A – Ships Stores Declaration and Clearance Certificate

A link to the Portable Document Format (PDF) of this form is provided below. The content of the form is duplicated in HTML following the PDF link.

PDF (1.5 Mb) [help with PDF files]

1. I hereby certify that the goods described above were received on board the ship/aircraft (Vessel name – Aircraft number) at (Place) on this ___ day of ___.

2. I hereby certify that the information given above is true and complete in every respect and that the vessel/aircraft (Name of vessel/aircraft number) qualifies for ships stores under classification No. ___.

Clearance certificate

(Do not use this area)

3. The ship/aircraft as specified above qualifies for ships stores as stated and cleared/departed on a voyage/flight to (Name of country (or customs office in Canada))

(A) For fishing ships show duration of voyage ___ days

(B) In case of unusual delay in clearance explain:


(For supplier)

(A) Section 2 is to be completed by inserting the classification number applicable to the ship or aircraft receiving supplies subject to drawback under the Goods Imported and Exported Refund and Drawback Regulations.

(B) Original of this form is required for drawback claim.

Customs date stamp

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