§ 141.85 - Pro forma invoice.

§ 141.85 Pro forma invoice.

A pro forma invoice submitted in accordance with any provision of this chapter shall be in substantially the following form:

Pro Forma Invoice

Importers Statement Of Value Or The Price Paid In The Form Of An Invoice

Not being in possession of a commercial seller's or shipper's invoice I request that you accept the statement of value or the price paid in the form of an invoice submitted below:

Name of shipper

address ________________________

Name of seller

address ________________________;.

Name of consignee

address ________________________.

Name of purchaser

address ________________________.

The merchandise (has) (has not) been purchased or agreed to be purchased by me.

The prices, or in the case of consigned goods the values, given below are true and correct to the best of my knowledge and belief, and are based upon: (Check basis with an “X”)

(a) The price paid or agreed to be paid (__) as per order dated ____________.

(b) Advices from exporter by letter ( - —) by cable (__) dated ____________.

(c) Comparative values of shipments previously received (__) dated ____________.

(d) Knowledge of the market in the country of exportation (__) ____________.

(e) Knowledge of the market in the United States (if U.S. Value) (__) ____________.

(f) Advice by CBP (__) ____________.

(g) Other (__) ______.

A - Case marks numbers B - Manufacturer

______.

A—Case marks numbers	B—Manufacturer's item No. symbol or brand	C - Quantities C—Quantities and full description	D - Unit D—Unit purchase price (currency)	E - Total E—Total purchase price (currency)	F - Unit F—Unit foreign value G	- Total G—Total foreign value

Check which of the charges below are, and which are not included in the prices listed in columns “D” and “E”:

Amount	Included	Not included
Packing
Cartage
Inlandfreight
Wharfage and loading abroad
Lighterage
Ocean freight
U.S. duties
Other charges (identify by name and amount)
Total

Country of origin ________________________.

If any other invoice is received, I will immediately file it with an authorized CBP officerofficial.

(Signature of person

making invoice)

(Title and firm name)

Date

[T.D. 73-17573–175, 38 FR 17447, July 2, 1973, as amended by T.D. 85-3985–39, 50 FR 9612, Mar. 11, 1985]