NORTH AMERICAN FREE TRADE AGREEMENT …

DEPARTMENT OF THE TREASURYUNITED STATES CUSTOMS SERVICENORTH AMERICAN free TRADE AGREEMENTCERTIFICATE OF ORIGIN19 CFR , EXPORTER NAME AND ADDRESS2. BLANKET PERIOD (DD/MM/YY)4. IMPORTER NAME AND ADDRESS3. PRODUCER NAME AND ADDRESSFROMTOTAX IDENTIFICATION NUMBER:TAX IDENTIFICATION OF GOOD(S) TARIFFCLASSIFICATIONNUMBER ORIGINI CERTIFY THAT: THE INFORMATION ON THIS DOCUMENT IS TRUE AND ACCURATE AND I ASSUME THE RESPONSIBILITY FOR PROVING SUCH REP-RESENTATIONS. I UNDERSTAND THAT I AM LIABLE FOR ANY FALSE STATEMENTS OR MATERIAL OMISSIONS MADE ON OR IN CON-NECTION WITH THIS DOCUMENT; I AGREE TO MAINTAIN, AND PRESENT UPON REQUEST, DOCUMENTATION NECESSARY TO SUPPORT THIS CERTIFICATE, AND TOINFORM, IN WRITING, ALL PERSONS TO WHOM THE CERTIFICATE WAS GIVEN OF ANY CHANGES THAT COULD AFFECT THE ACCU-RACY OR VALIDITY OF THIS CERTIFICATE; THE GOODS ORIGINATED IN THE TERRITORY OF ONE OR MORE OF THE PARTIES, AND COMPLY WITH THE origin REQUIREMENTSSPECIFIED FOR THOSE GOODS IN THE NORTH AMERICAN free TRA

NORTH AMERICAN FREE TRADE AGREEMENT CERTIFICATE OF ORIGIN INSTRUCTIONS Customs Form 434 (121793)(Back) For purposes of obtaining preferential tariff treatment, this document must be completed legibly and in full by the exporter

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