Trade Agreement Certificate of Origin Form

Trade Agreement Certificate of Origin Form
Provide the exporter, importer, shipment, goods, and origin details needed to prepare a certificate of origin for a trade agreement shipment.
Exporter Information
Exporter legal/business name
Street address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Contact person name
First NameMiddle NameLast Name
Email address
example@example.com
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Importer and Shipment Details
Importer Name
Importer Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Shipping Date
MonthDayYear
Date
Port of Loading
Port of Discharge
Destination Country
Goods and Origin Declaration
Product Description
Harmonized System / Commodity Code
Quantity
Unit of Measure
Country of Origin
Basis for Origin
Declaration Statement
Certification Signature
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