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


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