CBI Declaration
I, ____________________________,
(name), hereby declare that the articles described below (a) were produced or manufactured in ________________ (country) by means of processing operations performed in that country as set forth below and were also subjected to processing operations in the other beneficiary country or countries (including the Commonwealth of Puerto Rico and the U.S. Virgin Islands) as set forth below and (b) incorporate materials produced in the country named above or in any other beneficiary country or countries (including the Commonwealth of Puerto Rico and the U.S. Virgin Islands) or in the customs territory of the United States (other than the Commonwealth of Puerto Rico) as set forth below:
Number and date of invoices | Description of articles and quantity | Processing operations performed on articles | Material produced in a beneficiary country or in the U.S. | ||
Description of processing operations and country of processing | Direct costs of processing operations | Description of material, production process, and country of production | Cost or value of material | ||
Date _______________________________
Address _______________________________
Signature _______________________________
Title_______________________________
19 C.F.R. §10.198