Revenue CanadaCustoms and ExciseRevenue CanadaDouanes et AcciseCANADA CUSTOMS INVOICEFACTURE DES DOUANES CANADIENNESPageofde1.Vendor (Name and Address) Vendeur (Nom et adresse)2.Date of Direct Shipment to Canada/Date d expedition directe vers ie Canade3.Other References (include Purchaserys Order No.) Autres reterences(inclure ie n de commande de acheteur) 4.Consignee (Name and Address) Destinataire (Nom et adresse)5.Purchasers Name and Address(if other than Consignee)Nom et adresse de acheteur(Sll differe du destinataire)6.Country of Transhipment/Pays de transbordement7.Country of Origin of Goodspays d origine des marchandisesIF SHIPMENT INCLUDES GOODS OF DIFFERENT ORIGINS ENTER ORIGINS AGAINST ITEMA IN12 SIL EXPEDON COMPREND DES MARCHANDISES DORIGINESDIFFERENTES PRECISER LEUR PROVENANCE EN128.Transportation Give Mode and Place of Direct Shipment to CanadaTransport Preciser mode et point d expedition directe vercte vers ie canada9.Condirtions of Sale and Terms of Payment(i.e Saie. Consignment Shipment, Leased Goods, etd.)Conditions de vente et modaitites de paiement(P.ex vente, expedition en consignation, location, de marchandises, etc)10.Currency of Settlement/Devises du paiement11.No ofPkgsNore decolis12.Specification of Commodities (Kind of Packages,Marks,and Numbers,General Description and Characteristics, ie Grade, Quality)Designation des articles (Nature des colis, marques et numeros, description ger erale et caracteristiques, P ex classe, qualite)13. Quantity(State Unit)Quantite(Preciser unite)Selling Price/Prix de vente14.Unit PricePrix unitaire15. Total18.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 tactures16. Total Weight/Poids Total17.Invoice TotalTotal de la factureNetGross/Brutcommerciaies ci-attachees cocher cette casecommercial invoice No. 1 N de la factre commerciaie19.Exporters Name and Address(if other than Vendor)Nom et adresse de exportateur(sll differe du vendeur)20.Originator (Name and Address)/Expediteur d origine(Nom et adresse)21.Departmental Rulikg(if applicable)/Decision du Ministere(S lly a lieu)22.If fields 23 to 25 are not applicable, check this boxSi ies zones 23 e 25 sont sans objet, cocher cette case23.if included in field 7 indicate amountSi compris dans ie total a ia zone 17, preciser()Transportation charges, expenese and insurancefrom the place of direct shipment to CanadaLes frais de transport, depenses et assurancesa partir du point of expedition directe vers is Canada.24.If not included in field 17 indicate amountSi non compris dans le total a ie zone 17, Dreciser()Transportation charges, expense and insuranceto the place of direct shipment to CanadaLes frais de transport, depenses et assurances Iusqu au point d of expedition directd vers ie Canada25.Check (if applicable)Cochet (slly a liso)()Royalty payments or subsequent proceede arepaid or payable by the purchaser Des redevances ou prodults ont ete ou serontVerses par acheteur()Amounts for commissions other than buyingcommissionsLes commissions autres que celles verseesPour achat()Costs for const: action, erection and assemblyincurred atter importation into CanadaLes couts de construction, d erection etd assemblage, pres imporaation au.Canada()The purchaser has supplied goods or servicesfor use in the production of these goodsLacheteur a fouml des merchandises ou desServices pour ia production des merchandises()Export packingLe cout de emballage d exportation()Export packingLe cout de emballage d exportation