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Certificate of origin PDF Form: What You Should Know

Date (month, day, year) when goods entered the territory of the United States Form A — CERTIFICATE OF ORIGIN. 1. Goods consigned to (Consignee's name, address, country). 2. Goods consigned to (Consignee's name, address, country). 3. Date (month, day, year) when goods entered the territory of the United States. Note. A completed Form 434 must be signed and verified by all individuals to whom the required information is required to be provided, and at a place accessible to the public of the exporting entity. See “ADDITIONAL DOCUMENTS” on the side. Please note: Only one certification of origin is required for each single shipment of identical goods entered into the United States. All individual consignees are responsible for their own certification of origin, which must be obtained and signed (before being stamped) by all persons in the consignee's chain of custody (or by an employee appointed by the consignee). The consignee and the consignee's agent must ensure compliance with the Customs Form 434. CUSTOMS ADMINISTRATION: To order a copy of the C/O Form 434, call and ask to speak with Customs, or visit the website: (If the link is not working, call). Certification of Origin. (Certification of Origin). Please send: 1. C/O. Of: U.S. Department of Commerce 3100 Connecticut Ave. NW, Suite 434 Washington, DC 20009 2. Form, containing the following information: 4. The original or certified true copy of form (as stamped or otherwise evidenced), in one original record, with all the following: (a) Date; (b) Name of the sender; (c) Address of sender; (d) Telephone/fax number and email address of the sender; Certification of Origin. (Certification of Origin).

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