Email to:

Supplier Name and Address
(Need complete address)

Your name and address
(Need complete address)

Date Shipped

Reference Numbers:
Carrier Name and Tracking Number (if available)

Currency Code

The goods were manufactured or grown in the USA. If the goods are of USA origin you will need a NAFTA Certificate if the value is greater than $2500.00 CDN. By adding your name below and emailing this statement you are considered to have signed the statement. (Yes or No)

Your name