Revenue Canada Revenu Canada CANADA CUSTOMS INVOICE
Customs and Excise Douanes et Accise FACTURE DES DOUANES CANADIENNES
Page of
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1. Vendor (Name and Address) / Vendeur (Nom et adresse)
2. Date of Direct Shipment to Canada / Date d axpedition directe vers le Canada
3. Other References (include Purchaser s Order No.)
Autres references (Inclure ie no de commande de I acheteur)
4. Consignee (Name and Address) / Destinataire (Nom et adresse)
5. Purchaser s Name and Address (If other than Consignee)
Nom et adresse de I acheteur (S il differe du destinataire)
6. Country of Transhipment / Pays de transbordement
7. Country of Origin of Goods
Pays d origine des machandises
IF SHIPMENT INCLUDES GOODS OF DIFFERENT ORIGINS
ENTER ORIGNS AGAINST ITEMS IN 12.
SL L EXPEDITION COMPREND DES
MARCHANDISES D ORIGINES DIFFERENTES.
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