Certification of Origin
Instructions
For purposes of obtaining preferential tariff treatment at the time of entry, this document must be completed legibly and in
full, and be in the possession of the Importer at the time the declaration is made. This document may be completed by the
Producer, Exporter and/or Importer.
The certification of origin should include the following data fields and information:
Field 1: BLANKET PERIOD (DD/MM/YYYY)
"FROM" is the date upon which the certification becomes applicable to the good covered by the blanket Certification (it may be prior to
the date of signing this certification). "TO" is the date upon which the blanket period expires. In no instance should that certification
exceed a 12-month period, and any information provided should be updated in the event any previously-issued certification no longer
applies. Complete this field if applicable.
Field 2: SINGLE SHIPMENT
If the certification is only applicable to a single shipment this should be indicated by typing "YES" to the right of Single Shipment and
providing the Invoice Number applicable to the single shipment. Complete this field if applicable.
Field 3: CERTIFIER'S NAME AND ADDRESS
Provide the Certifier’s name, title, address (including country), e-mail address, and telephone number. Indicate whether the Certifier is the
Exporter, or Producer, or Importer in accordance with Article 5.2 (Claims for Preferential Treatment) of the Agreement.
This is a mandatory field.
Field 4: EXPORTER'S NAME AND ADDRESS
Provide the exporter's name, address (including country), email address, and telephone number if different from the certifier.
The address of the exporter shall be the place of export of the good in a Party's territory. This address must be in the territory of a
CUSMA Party (Canada, US or Mexico). This information is not required if the producer is completing the certification of origin and does
not know the identity of the exporter. In these circumstances, state "Unknown".
Field 5: PRODUCER'S NAME AND ADDRESS
Provide the producer's name, address (including country), email address, and telephone number if different from the certifier or exporter.
The address of a producer shall be the place of production of the good in a Party's territory. This address must be in the territory of a
CUSMA Party (Canada, US or Mexico). If there are multiple producers, state "Various" or provide a list of the producers. A person that
wishes for this information to remain confidential may state "Available upon request by the importing authorities". If the producer is
unknown, state "Unknown".
Field 6: IMPORTER'S NAME AND ADDRESS
Provide, if known, the importer's name, address, email address, and telephone number. The address of the importer shall be in a Party's
territory. This address must be in the territory of a CUSMA Party (Canada, US or Mexico). If there are multiple importers, state "Various"
and provide a list of the importers upon request by the CBSA. If the importer is unknown, state "Unknown".
Field 7: PART NUMBER & DESCRIPTION OF GOODS
Provide a full description of each good subject to the certification. The description should be sufficient to relate it to the invoice
description and to the Harmonized System (HS) description of the good. The description can include part number(s) in addition to the full
description. If the certification of origin covers a single shipment of a good, indicate, if known, the invoice number related to the
exportation.
Field 8: HS CLASSIFICATION NUMBER
For each good described in the certification, identify the HS tariff classification to six digits as specified for each good in the Rules of
Origins set forth. If the good is subject to a specific rule of origin that requires eight digits, identify the HS tariff classification to an eight
digit level.
