Box 33043 Confederation Park, Saskatoon S7L 1J2, Canada
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1. Vendor Name Phone No Street Address City Country Postal/ZIP Code
2. Date of Direct Shipment to Canada 3. Other References (include Purchasers' Order No.) PAPS # or PARS #
4. Consignee Name Phone No Street Address City Country Postal/ZIP Code
5. Purchaser's Name and Address (if other than Consignee) 6. Country of Transhipment
7. Country of Origin (IF SHIPMENT INCLUDES GOODS OF DIFFERENT ORIGINS ENTER ORIGINS AGAINST ITEMS IN 12) 8. Transportation: Give Mode and Place of Direct Shipment to Canada
9. Conditions of Sale and Terms of Payment 10. Currency of Settlement
11. No of Pkgs
12. Specifications of Commodities (Kind of Packages, Marks and Numbers, General Description and Characteristics e.g. Grade, Quality)
13. Quantity (state unit)
Selling Price
14. Unit Price
15. Total
HS Tariff Classification #
Truck Frieght
Brokerage Fee
18. If any of fields 1 to 17 are included on attached commercial invoice, 'Check this box Commercial Invoice No.
16. Total Weight
Net
Gross
17. Invoice Total
19. Exporter's Name (if other than Vendor) Exporter's Address Exporter's City Exporter's Country Exporter's Postal/ZIP Code 21. Departmental Ruling (if applicable)
20. Originator Name Originator Address Originator City Originator Country Originator Postal/ZIP Code
22. If Fields 23 to 25 are not applicable, check this box
(i) Transportation charges, expenses and insurance from the place of direct shipment to Canada (ii) Costs for construction, erection and assembly incurred after importation into Canada (iii) Export Packing
(i) Transportation charges, expenses and insurance from the place of direct shipment to Canada (ii) Amount for commissions other than buying commissions (iii) Export Packing
(i) Royalty payments or subsequent proceeds are paid or payable by the purchaser
(ii) The purchaser has supplied goods or services for use in the production of these goods
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