Transcription of Certificate of Origin - dhl-usa.com
1 Certificate of Origin The undersigned _____(Owner or Agent) for _____(Shipper s Name and Address) declares the following listed goods shipped on _____ (Name of Carrier) on _____(shipment date) consigned to_____ are the products of the United States of America. State of _____ Country of _____ Sworn to me _____ This day of _____20_ _____ (Signature of Owner or Agent) The _____, a recognized Chamber of Commerce under the laws of the State of _____ has examined the manufacturer s invoice or shipper s affidavit concerning the Origin of the merchandise and, according to the best of its knowledge and belief, finds the products named originated in the United States of America, (North America).
2 Secretary _____ Marks and Numbers No. of Pkgs Boxes or Cases Weight in Kilos Full Description of Item Gross Net
