| 1. Exporter Name & Address: | ||
| 2. Producer Name & Address: | ||
| 3. Importer Name & Address: | ||
| 4. Description of Article: | ||
| 5. Preference Group: | ||
| Group | Each Description Below Is Only a Summary of the Cited CFR Provision. | 19 CFR |
| A | Apparel assembled from U.S. formed, dyed, printed and finished fabrics or fabric components, or U.S. formed knit-to-shape components from U.S. or Andean yarns | 10.243(a)(1)(i). |
| B | Apparel assembled from Andean chief value llama, alpaca or vicuña fabrics, fabric components, or knit-to-shape components, from Andean yarns | 10.243(a)(1)(ii). |
| C | Apparel assembled from fabrics or yarns considered as being in short supply in the NAFTA | 10.243(a)(1)(iii). |
| D | Apparel assembled from fabrics or yarns designated as not available in commercial quantities in the United States | 10.243(a)(1)(iv). |
| E | Apparel assembled from a combination of two or more yarns, fabrics, fabric components, or knit-to-shape components described in preference groups A though D | 10.243(a)(2). |
| F | Handloomed, handmade, or folklore textile and apparel goods | 10.243(a)(3). |
| G | Brassieres assembled in the U.S. and/or one or more Andean beneficiary countries | 10.243(a)(4). |
| H | Textile luggage assembled from U.S. formed fabrics from U.S. yarns | 10.243(a)(5)&(6). |
| I | Apparel assembled from Andean formed fabrics, fabric components, or knit-to-shape components from U.S. or Andean yarns, whether or not also assembled, in part, from yarns, fabrics and fabric components described in preference groups A through D | 10.243(a)(7). |
| 6. U.S./Andean Fabric Producer Name & Address: | ||
| 7. U.S./Andean Yarn Producer Name & Address: | ||
| 8. Handloomed, Handmade, or Folklore Article: | ||
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| 9. Name of Short Supply Fabric or Yarn: | ||
| I certify that the information on this document is complete and accurate and I assume the responsibility for proving such representations. I understand that I am liable for any false statements or material omissions made on or in connection with this document. I agree to maintain, and present upon request, documentation necessary to support this certificate. | ||
| 10. Authorized Signature: | ||
| 11. Company: | ||
| 12. Name: (Print or Type) | ||
| 13. Title: | ||
| 14. Date: (DD/MM/YY) | ||
| 15. Blanket Period: | ||
| From: | ||
| To: | ||
| 16. Telephone: | ||
| Facsimile: | ||