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Proof of Origin of Imported Goods Regulations (SOR/98-52)

Regulations are current to 2024-05-28 and last amended on 2023-06-23. Previous Versions

SCHEDULE(Subsections 4(2) and (3))Exporter’s Statement of Origin

I certify that the goods described in this invoice or in the attached invoice # blank line were produced in the beneficiary country of blank line and that at least blank line per cent of the ex-factory price of the goods originates in the beneficiary country/countries of blank line.

  • Name and title
  • Corporation name and address
  • Telephone and fax numbers
  • Signature and date (day/month/year)

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