(i) A declaration from the person who performed such repairs or alterations, in substantially the following form:
I/We, ______, declare that the goods herein specified are the goods which, in the condition in which they were exported from the United States, were received by me (us) on ________, 19__, from ______ (name and address of owner or exporter in the United States); that they were received by me (us) for the sole purpose of being repaired or altered; that only the repairs or alterations described below were performed by me (us); that such repairs or alterations were (were not) performed pursuant to a warranty; that the full cost or (when no charge is made) value of such repairs or alterations is correctly stated below; and that no substitution whatever has been made to replace any of the goods originally received by me (us) from the owner or exporter thereof mentioned above.
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Description of goods and of repairs or alterations |
Full cost or (when no charge is made) value of repairs or alterations (see Subchapter II, Chapter 98, HTSUS) |
Total value of goods after repairs or alterations |
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Date
Signature
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Address
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Capacity
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(ii) A declaration by the owner, importer, consignee, or agent having knowledge of the pertinent facts in substantially the following form:
I, ________, declare that the (above) (attached) declaration by the person who performed the repairs or alterations abroad is true and correct to the best of my knowledge and belief; that the goods ____ were ____ were not (check one) subject to NAFTA drawback; that such goods were exported from the United States for repairs or alterations from ____ (port) on _________, 19__; and that the goods entered in their repaired or altered condition are the same goods that were exported on the above date and that are identified in the (above) (attached) declaration.
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Date
Signature________________________
Address________________________
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Capacity
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