Revenue
Canada
Customs and Excise Revenue Canada Douanes et Accise CANADA CUSTOMS INVOICE FACTURE DES DOUANES CANADIEN
4. Consignee (Name and Address) Destinataire (Nom et adresse)
5. Purchaser's Name and Address(if other than Consignee)
Nom et adresse de í acheteur(S'll differe du destinataire)
1. Vendor (Name and Address) Vendeur (Nom et adresse)
2.Date of Direct Shipment to Canada/Date d' expedition directe vers ie Canade
3.Other References (include Purchaserys Order No.)
Autres reterences(inclure ie n de commande de í acheteur)
7. Country of Origin of Goods
pays d' origine des marchandises
Conditions de vente et modaitites de paiement
8.Transportation Give Mode and Place of Direct Shipment to Canada 6. Country of Transhipment /Pays de transbordement
(P.ex vente, expedition en consignation, location, de marchandises, etc)
10.Currency of Settlement/Devises du paiement
Transport Preciser mode et point d'expedition directe vercte vers ie canada 9. Condirtions of Sale and Terms of Payment
(i.e Saie. Consignment Shipment, Leased Goods, etd.)
et caracteristiques,, P ex classe, qualite)11.No of Pkgs
Nore de
colis 1(Pr
12.Specification of Commodities (Kind of Packages,Marks,and Numbers,General
Description and Characteristics, ie Grade, Quality)Designation des articles (Nature des colis, marques et numeros, description ger erale 18. if any Of fields 1 to 17 are included on an attached commercial invoice, check this box
si tout renseignement relatlvement aux zones 1 e 17 ligure sur une ou des tactures
□16. Total Weig Poids Total Net commerciaies ci-attachees cocher cette case
commercial invoice No.1N de la factre
commerciaie 21.Departmental Rulikg(if applicable)/Decision du Ministere(S'lly a lieu)
22.If fields 23 to 25 are not applicable, check this box
19.Exporter's Name and Address(if other than Vendor)
Nom et adresse de í exportateur(s'll differe du vendeur)20.Originator (Name and Address)/Expediteur d' origine(Nom et adresse)
(Ⅰ)Transportation charges, expenese and insurance from the place of direct shipment to Canada
Les frais de transport, depenses et assurances
Si ies zones 23 e 25 sont sans objet, cocher cette case
23.if included in field 7 indicate amount
24.If not included in field 17 indicate amount a partir du point of expedition directe vers is Les frais de transport, depenses et assurances Iusqu' au point d' of expedition directd vers ie Canada
Si non compris dans le total a ie zone 17, Dreciser
(Ⅰ)Transportation charges, expense and insurance
to the place of direct shipment to Canada Si compris dans ie total a ia zone 17, preciser
Canada.
Les commissions autres que celles versees Pour í achat
incurred atter importation into Canada
Les couts de construction, d' erection et
(Ⅱ)Amounts for commissions other than buying
commissions
d' assemblage,, pres imporaation au.Canada
(Ⅱ)Costs for const: action, erection and assembly
(Ⅲ)Export packing
Le cout de í emballage d' exportation (Ⅲ)Export packing
Le cout de í emballage d' exportation
Page
of de
OICE
ADIENNES e)
directe vers ie Canade
eur)
IF SHIPMENT INCLUDES GOODS OF DIFFERENT ORIGINS ENTER ORIGINS AGAINST ITEMA IN12SIL' EXPEDON COMPREND DES MARCHANDISES D'
DIFFERENTES PRECISER LEUR PROVENANCE EN12
ORIGINES
c)
14.Unit Price
Prix unitaire 15. Total
13. Quantity
(State Unit)
Quantite
(Preciser í unite)Selling Price/Prix de vente Weight/Poids Total
17. Invoice Total Total de la facture
Gross/Brut (Nom et adresse)
□
25.Check (if applicable)
Verses par í acheteur
paid or payable by the purchaser
Cochet (s'lly a liso)
(Ⅱ)Royalty payments or subsequent proceede are
Des redevances ou prodults ont ete ou seront