RevenueCanadaCustomsand Excise
Revenue CanadaDouanes et Accise
CANADA CUSTOMS INVOICEFACTURE DES DOUANES CANADIEN
2.Date of Direct Shipment to Canada/Date d' expedition directe vers ie Canade
1. Vendor (Name and Address) Vendeur (Nom et adresse)
3.Other References (include Purchaserys Order No.)Autres reterences(inclure ie n de commande de Í acheteur)
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)
6. Country of Transhipment/Pays de transbordement
7. Country of Origin of Goods
pays d' origine des marchandises
8.TransportationGiveModeandPlaceofDirectShipmentto9. Condirtions of Sale and Terms of PaymentCanada
TransportPrecisermodeetpointd'expeditiondirecteverctevers(i.e Saie. Consignment Shipment, Leased Goods, etd.)ie
canadaConditions de vente et modaitites de paiement
(P.ex vente, expedition en consignation, location, de marchandises, etc)
10.Currency of Settlement/Devises du paiement
11.No of12.Specification of Commodities (Kind of Packages,Marks,and Numbers,GeneralPkgsNore decolis
Description and Characteristics, ie Grade, Quality)
Designation des articles (Nature des colis, marques et numeros, description ger eraleet caracteristiques,, P ex classe, qualite)
1
(Pr
18. if any Of fields 1 to 17 are included on an attached commercial invoice, check this boxsi tout renseignement relatlvement aux zones 1 e 17 ligure sur une ou des tacturescommerciaies ci-attachees cocher cette casecommercialinvoiceNo.1Ndelafactrecommerciaie16. Total WeigPoids Total
□
Net
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)
21.DepartmentalRulikg(ifapplicable)/DecisionduMinistere(S'lly22.If fields 23 to 25 are not applicable, check this boxa lieu)
Si ies zones 23 e 25 sont sans objet, cocher cette case
23.if included in field 7 indicate amountSi compris dans ie total a ia zone 17, preciser
24.If not included in field 17 indicate amountSi non compris dans le total a ie zone 17, Dreciser
(Ⅰ)Transportation charges, expenese and insurance(Ⅰ)Transportation charges, expense and insurancefrom the place of direct shipment to CanadaLes frais de transport, depenses et assurancesa partir du point of expedition directe vers is
to the place of direct shipment to CanadaLes frais de transport, depenses et assurancesIusqu' au point d' of expedition directd vers ie Canada
Canada.
(Ⅱ)Amounts for commissions other than buyingcommissions
(Ⅱ)Costs for const: action, erection and assemblyincurred atter importation into CanadaLes couts de construction, d' erection etd' assemblage,, pres imporaation au.Canada
(Ⅲ)Export packing
(Ⅲ)Export packing
Le cout de Í emballage d' exportation
Le cout de Í emballage d' exportationLes commissions autres que celles verseesPour Í achat
Page
OICEADIENNES
ofde
directe vers ie Canade
eur)
e)
IF SHIPMENT INCLUDES GOODS OF DIFFERENT ORIGINS ENTER ORIGINS AGAINST ITEMA IN12SIL' EXPEDON COMPREND DES MARCHANDISES D'ORIGINES
DIFFERENTES PRECISER LEUR PROVENANCE EN12
c)
13. Quantity(State Unit)Quantite(Preciser Í unite)
14.Unit PricePrix unitaire
Selling Price/Prix de vente
15. TotalWeight/Poids Total
Gross/Brut
17. Invoice TotalTotal de la facture
(Nom et adresse)
□
25.Check (if applicable)Cochet (s'lly a liso)
(Ⅱ)Royalty payments or subsequent proceede arepaid or payable by the purchaser
Des redevances ou prodults ont ete ou serontVerses par Í acheteur
□(Ⅱ)The purchaser has supplied goods or servicesfor use in the production of these goodsL'acheteur a fouml des merchandises ou desServices pour ia production des merchandises□
