Cbp Form 434 2014

DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection OMB No. 1651-0098 Exp. 10-31-2016 NORTH AMERICAN FREE TRADE AGREEMENT CERTIFICATE OF ORIGIN 19 CFR 181. COMPANY 11c. NAME 11d. TITLE 11e. DATE 11g. EMAIL 11f. TELEPHONE NUMBERS Voice Facsimile CBP Form 434 11/14 PAPERWORK REDUCTION ACT STATEMENT An agency may not conduct or sponsor an information collection and a person is not required to respond to this information unless it displays a current valid OMB control number and an expiration date. 11 181. 22 1. EXPORTER NAME ADDRESS AND EMAIL 2. BLANKET PERIOD FROM TO TAX IDENTIFICATION NUMBER 3. PRODUCER NAME ADDRESS AND EMAIL 4. IMPORTER NAME ADDRESS AND EMAIL HS TARIFF PREFERENCE CLASSIFICATION PRODUCER NET COST CRITERION NUMBER DESCRIPTION OF GOOD S COUNTRY OF ORIGIN 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 AND PRESENT UPON REQUEST DOCUMENTATION NECESSARY TO SUPPORT THIS CERTIFICATE AND TO INFORM IN WRITING ALL PERSONS TO WHOM THE CERTIFICATE WAS GIVEN OF ANY CHANGES THAT COULD AFFECT THE ACCURACY OR VALIDITY OF THIS CERTIFICATE THE GOODS ORIGINATED IN THE TERRITORY OF ONE OR MORE OF THE PARTIES AND COMPLY WITH THE ORIGIN REQUIREMENTS SPECIFIED FOR THOSE GOODS IN THE NORTH AMERICAN FREE TRADE AGREEMENT AND UNLESS SPECIFICALLY EXEMPTED IN ARTICLE 411 OR ANNEX 401 THERE HAS BEEN NO FURTHER PRODUCTION OR ANY OTHER OPERATION OUTSIDE THE TERRITORIES OF THE PARTIES AND PAGES INCLUDING ALL ATTACHMENTS. 11a. AUTHORIZED SIGNATURE 11b. NOTE 2 A tariff rate quota is not a quantitative restriction. by 1 2 or 3 depending on whether this certificate was based upon 1 your knowledge of whether the good qualifies as an originating good 2 your reliance on the producer s written representation other than a Certificate of Origin that the good qualifies as an originating good or 3 a completed and signed Certificate for the good voluntarily provided to the exporter by the producer. calculated according to the net cost method otherwise indicate NO. If the RVC is calculated over a period of time further identify the beginning and ending dates MM/DD/YYYY of that period. Reference Article 402. 1 402. 5. Identify the name of the country MX or US for agricultural and textile goods exported to Canada US or CA for all goods exported to Mexico or CA or MX for all goods exported to the United States to which the preferential rate of CBP duty applies as set out in Annex 302. 2. NOTE 1 This criterion does not apply to goods that wholly originate in Canada or the United States and are imported into either country. NOTE 2 A tariff rate quota is not a quantitative restriction. by 1 2 or 3 depending on whether this certificate was based upon 1 your knowledge of whether the good qualifies as an originating good 2 your reliance on the producer s written representation other than a Certificate of Origin that the good qualifies as an originating good or 3 a completed and signed Certificate for the good voluntarily provided to the exporter by the producer. calculated according to the net cost method otherwise indicate NO. If the RVC is calculated over a period of time further identify the beginning and ending dates MM/DD/YYYY of that period. 2 Section A or B please specify. A good listed in Appendix 703. 2B. 7 is also exempt from quantitative restrictions and is eligible for NAFTA preferential tariff treatment if it meets the definition of qualifying good in Section A of Annex 703. 2. NOTE 1 This criterion does not apply to goods that wholly originate in Canada or the United States and are imported into either country. NOTE 2 A tariff rate quota is not a quantitative restriction. by 1 2 or 3 depending on whether this certificate was based upon 1 your knowledge of whether the good qualifies as an originating good 2 your reliance on the producer s written representation other than a Certificate of Origin that the good qualifies as an originating good or 3 a completed and signed Certificate for the good voluntarily provided to the exporter by the producer. S. description of the good. If the Certificate covers a single shipment of a good include the invoice number as shown on the commercial invoice. If not known indicate another unique reference number such as the shipping order number. For each good described in Field 5 identify the H. S. tariff classification to six digits. If the good is subject to a specific rule of origin in Annex 401 that requires eight digits identify to eight digits using the H. 2 in accordance with the Marking Rules or in each party s schedule of tariff elimination. For all other originating goods exported to Canada indicate appropriately MX or US if the goods originate in that NAFTA country within the meaning of the NAFTA Rules of Origin Regulations and any subsequent processing in the other NAFTA country does not increase the transaction value of the goods by more than seven percent otherwise indicate JNT for joint production. Reference Annex 302. 2 This field must be completed signed and dated by the exporter. When the Certificate is completed by the producer for use by the exporter it must be completed signed and dated by the producer.