Canada Border Services Agency Agence des services frontaliers du Canada CANADA CUSTOMS INVOICE FACTURE DES DOUANES...
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Canada Border Services Agency Agence des services frontaliers du Canada CANADA CUSTOMS INVOICE FACTURE DES DOUANES CANADIENNES 1. Vendor (name and address) - Vendeur (nom et adresse) Parks Manor 711 old York Drive Richmond, VA 23223 2 Help Aide PROTECTED PROTEGE Restore - Restaurer when completed une fois rempli Page of 1 de 1 Date of direct shipment to Canada - Date d'expdition directe vers le Canada 2017/03/01 4. Consignee (name and address)- Destinataire (nom et adresse) Square Angel 2641 St. Marys Road Winnipeg, MB 8. R3C 0C4 Transportation: Give mode and place of direct shipment to Canada Transport: Prcisez mode et point d'expdition directe vers le Canada Truck Richmond, VA 3. Other references (include purchaser's order No.) 5. Autres rfrences (inclure le n de commande de l'acheteur) 10-77B6 Purchaser's name and address (if other than consignee) Nom et adresse de l'acheteur (s'il diffre du destinataire) Circle Tags 78 Yoho Valley Road Radium Hot Springs, BC VOA 1M0 6. Country of transhipment - Pays de transbordement 7. Country of origin of goods Pays d'origine des marchandises USA 9. Conditions of sale and terms of payment IF SHIPMENT INCLUDES GOODS OF DIFFERENT ORIGINS ENTER ORIGINS AGAINST ITEMS IN 12. SI L'EXPDITION COMPREND DES MARCHANDISES D'ORIGINES DIFFRENTES, PRCISEZ LEUR PROVENANCE EN 12 (i.e. sale, consignment shipment, leased goods, etc.) Conditions de vente et modalits de paiement (p. ex. vente, expdition en consignation, location de marchandises, etc.) Net 30 days 10. Currency of settlement - Devises du paiement 11. Number of 12. Specification of commodities (kind of packages, marks and numbers, general description and characteristics, i.e., grade, quality) packages Nombre de colis Dsignation des articles (nature des colis, marques et numros, description gnrale et caractristiques, p. ex. classe, qualit) 55 sleeping bags 10/55 cardboard boxes Parties in the transaction are not related CUSMA is not applicable 18. If any of fields 1 to 17 are included on an attached commercial invoice, check this box Si tout renseignement relativement aux zones 1 17 figure sur une ou des factures commerciales ci-attaches, cochez cette case Commercial Invoice No. - N de la facture commerciale 19. Exporter's name and address (if other than vendor) Nom et adresse de l'exportateur (s'il diffre du vendeur) USD 13. Quantity (state unit) Quantit (prcisez l'unit) 550 Selling price - Prix de vente 14. Unit price 15. Total Prix unitaire 76.97 42,333.50 16. Total weight - Poids total 17. Invoice total Total de la facture Net Gross - Brut 7,500 8,000 20. Originator (name and address) - Expditeur d'origine (nom et adresse) 42,333.50 21. Agency ruling (if applicable) - Dcision de l'Agence (s'il y a lieu) 23. If included in field 17 indicate amount: Si compris dans le total la zone 17, prcisez: (i) Transportation charges, expenses and insurance from the place of direct shipment to Canada Les frais de transport, dpenses et assurances partir du point d'expdition directe vers le Canada (ii) Costs for construction, erection and assembly incurred after importation into Canada Les cots de construction, d'rection et d'assemblage aprs importation au Canada 1,250.00 22. If fields 23 to 25 are not applicable, check this box Si les zones 23 25 sont sans objet, cochez cette case 25. Check (if applicable): 24. If not included in field 17 indicate amount: Si non compris dans le total la zone 17, prcisez: (i) Transportation charges, expenses and insurance to the place of direct shipment to Canada Les frais de transport, dpenses et assurances jusqu'au point d'expdition directe vers le Canada (ii) Amounts for commissions other than buying commissions Les commissions autres que celles verses pour l'achat Cochez (s'il y a lieu): (i) Royalty payments or subsequent proceeds are paid or payable by the purchaser Des redevances ou produits ont t ou seront verss par l'acheteur (ii) The purchaser has supplied goods or services for use in the production of these goods L'acheteur a fourni des marchandises ou des services pour la production de ces marchandises (iii) Export packing CI1 (08/09) Le cot de l'emballage d'exportation (iii) Export packing Le cot de l'emballage d'exportation 750.00 Dans ce formulaire, toutes les expressions dsignant des personnes visent la fois les hommes et les femmes. If you require more space, please attach another sheet. - Si vous avez besoin de plus d'espace, veuillez joindre une autre feuille. BSF189 Canada Border Services Agency Agence des services frontaliers du Canada CANADA CUSTOMS INVOICE FACTURE DES DOUANES CANADIENNES 1. Vendor (name and address) - Vendeur (nom et adresse) Parks Manor 711 old York Drive Richmond, VA 23223 2 Help Aide PROTECTED PROTEGE Restore - Restaurer when completed une fois rempli Page of 1 de 1 Date of direct shipment to Canada - Date d'expdition directe vers le Canada 2017/03/01 4. Consignee (name and address)- Destinataire (nom et adresse) Square Angel 2641 St. Marys Road Winnipeg, MB 8. R3C 0C4 Transportation: Give mode and place of direct shipment to Canada Transport: Prcisez mode et point d'expdition directe vers le Canada Truck Richmond, VA 3. Other references (include purchaser's order No.) 5. Autres rfrences (inclure le n de commande de l'acheteur) 10-77B6 Purchaser's name and address (if other than consignee) Nom et adresse de l'acheteur (s'il diffre du destinataire) Circle Tags 78 Yoho Valley Road Radium Hot Springs, BC VOA 1M0 6. Country of transhipment - Pays de transbordement 7. Country of origin of goods Pays d'origine des marchandises USA 9. Conditions of sale and terms of payment IF SHIPMENT INCLUDES GOODS OF DIFFERENT ORIGINS ENTER ORIGINS AGAINST ITEMS IN 12. SI L'EXPDITION COMPREND DES MARCHANDISES D'ORIGINES DIFFRENTES, PRCISEZ LEUR PROVENANCE EN 12 (i.e. sale, consignment shipment, leased goods, etc.) Conditions de vente et modalits de paiement (p. ex. vente, expdition en consignation, location de marchandises, etc.) Net 30 days 10. Currency of settlement - Devises du paiement 11. Number of 12. Specification of commodities (kind of packages, marks and numbers, general description and characteristics, i.e., grade, quality) packages Nombre de colis Dsignation des articles (nature des colis, marques et numros, description gnrale et caractristiques, p. ex. classe, qualit) 55 sleeping bags 10/55 cardboard boxes Parties in the transaction are not related CUSMA is not applicable 18. If any of fields 1 to 17 are included on an attached commercial invoice, check this box Si tout renseignement relativement aux zones 1 17 figure sur une ou des factures commerciales ci-attaches, cochez cette case Commercial Invoice No. - N de la facture commerciale 19. Exporter's name and address (if other than vendor) Nom et adresse de l'exportateur (s'il diffre du vendeur) USD 13. Quantity (state unit) Quantit (prcisez l'unit) 550 Selling price - Prix de vente 14. Unit price 15. Total Prix unitaire 76.97 42,333.50 16. Total weight - Poids total 17. Invoice total Total de la facture Net Gross - Brut 7,500 8,000 20. Originator (name and address) - Expditeur d'origine (nom et adresse) 42,333.50 21. Agency ruling (if applicable) - Dcision de l'Agence (s'il y a lieu) 23. If included in field 17 indicate amount: Si compris dans le total la zone 17, prcisez: (i) Transportation charges, expenses and insurance from the place of direct shipment to Canada Les frais de transport, dpenses et assurances partir du point d'expdition directe vers le Canada (ii) Costs for construction, erection and assembly incurred after importation into Canada Les cots de construction, d'rection et d'assemblage aprs importation au Canada 1,250.00 22. If fields 23 to 25 are not applicable, check this box Si les zones 23 25 sont sans objet, cochez cette case 25. Check (if applicable): 24. If not included in field 17 indicate amount: Si non compris dans le total la zone 17, prcisez: (i) Transportation charges, expenses and insurance to the place of direct shipment to Canada Les frais de transport, dpenses et assurances jusqu'au point d'expdition directe vers le Canada (ii) Amounts for commissions other than buying commissions Les commissions autres que celles verses pour l'achat Cochez (s'il y a lieu): (i) Royalty payments or subsequent proceeds are paid or payable by the purchaser Des redevances ou produits ont t ou seront verss par l'acheteur (ii) The purchaser has supplied goods or services for use in the production of these goods L'acheteur a fourni des marchandises ou des services pour la production de ces marchandises (iii) Export packing CI1 (08/09) Le cot de l'emballage d'exportation (iii) Export packing Le cot de l'emballage d'exportation 750.00 Dans ce formulaire, toutes les expressions dsignant des personnes visent la fois les hommes et les femmes. If you require more space, please attach another sheet. - Si vous avez besoin de plus d'espace, veuillez joindre une autre feuille. BSF189
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