DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
SECTION II NON-ORIGINATING/UNKNOWN MATERIALS OR COMPONENTS
SECTION I PRODUCTION PROCESS
This questionnaire is sent to you pursuant to 19 CFR 181.72, The questionnaire will be used in
determining if the
described on the NAFTA Certificate of Origin (CO) dated
and signed by
originates under the NAFTA. If necessary, additional information may be requested at a later date.
If this box is checked, you are being sent this questionnaire as the producer
of the imported good.
If this box is checked, you are being sent this questionnaire because
If this box is checked, you are being sent this questionnaire as the exporter
and also the producer of the imported good. Complete the questionnaire.
identified you as the producer of the
material(s) used in the production of the good described above. Complete
You have until
to return the completed and signed questionnaire to the requesting CBP office. You may fax your response. If a
reply cannot be made by this date, please contact the CBP office by mail, telephone, or fax. If additional space is needed for your response, attach additional
pages as needed. When the verification is completed, the exporter/producer will receive a written determination of the findings. The producer of a verified
material will also be notified of the results of the verification of the material. The confidential business information collected on the questionnaire may only be
disclosed to those authorities responsible for the administration and enforcement of determinations of origin, and of customs and revenue matters.
The questionnaire must be signed and dated by an individual who can certify as to the accuracy of the information provided in the questionnaire. Failure to
complete and return this questionnaire may result in the denial of preferential treatment under the NAFTA.