Customs CU01
IMPORT Sheet
Date: ______________
1. Charge the GST portion of the HST & warehouse fees to account # ______________
2. Complete name and full address of the vendor/exporter:
Name: __________________________________________
Street: __________________________________________
City/Province/State: _________________________________
Postal Code/Zip Code: ________________________________
3. Description of Goods
Item
#
Description of Goods
Country of
Manufacture
# of
items
($)
value
per item
Total ($)
amount
1
2
3
4
5
6
7
8
9
10
4. Are the goods to be used exclusively in research or teaching? Yes No
5. Provide purchase order number if there is one: P.O. # _______________________
6. Your department: ______________________ Your name:_____________________
Ext. #: ___________________
7. If the item(s) purchased
are for an instrument or machine, what type of instrument
or machine is it? ___________________________
8. Are the item(s) perishables? Ye
s No
9. If the item(s) purchased is a book(s), please provide title(s):
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
SUBMIT
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