Adcom Worldwide - Customer Education Center

The information gathered in the following fields will be used to generate a completed PDF copy of the NAFTA Certificate of Origin document. Please provide all information requested.

1. EXPORTER NAME AND ADDRESS
TAX IDENTIFICATION NUMBER
2. BLANKET PERIOD
FROM (mm/dd/yyyy)
TO (mm/dd/yyyy)
3. PRODUCER NAME AND ADDRESS
TAX IDENTIFICATION NUMBER
4. IMPORTER NAME AND ADDRESS
TAX IDENTIFICATION NUMBER
Fields 5-10* will be completed below.*
11b. COMPANY
11c. NAME (Print or Type)
11d. TITLE
11f. TELEPHONE NUMBER
(Voice)
(Facsimile)

After you have completed the fields above, you must provide the DESCRIPTION OF GOOD(S) and related information. For each line item in this section, complete the fields below and click the Add Line Item button. When all line items have been added, continue with form submission below.

5. DESCRIPTION OF GOOD(S)
6. HS TARIFF CLASSIFICATION NUMBER
7. PREFERENCE CRITERION
8. PRODUCER
9. NET COST
10. Country of Origin

When the information above is correct and complete, click the Submit Form button below to generate a PDF copy of the completed NAFTA Certificate of Origin document for printing and/or download. You can also choose to forward a copy of the completed document directly to Adcom Worldwide by checking the box below. Please note that you will need to print and sign this form before faxing it to us.

I would like to email a copy of the NAFTA Certificate of Origin document directly to the following Adcom Worldwide office:

"Adcom Worldwide made sure our equipment arrived complete where it was needed and on time."

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