USMCA Certificate of Origin Form

Indicate the duration of the Certificate. The blanket period cannot exceed a period of one year.

Provide the Certifier’s company name, address (including country), e-mail address, and telephone number.

Provide the Exporter’s name, address (including country), e-mail address, and telephone number if different from the certifier. This information is not required if the producer is completing the certification of origin and does not know the identity of the exporter; in which case you may state “Unknown.” The address of the exporter shall be the place of export of the good in a Party’s territory. If the information is the same as the Certifier, you may state “Same as Certifier.”

Provide the Producer’s name, address (including country), e-mail address, and telephone number, if different from the certifier or exporter. If there are multiple producers, you may state “Various” or provide a list of producers. If this information is to remain confidential, you may state “Available upon request by the importing authorities”. The address of a producer shall be the place of production of the good in a Party’s territory. If the information is the same as the Certifier, you may state “Same as Certifier.”

Provide, if known, the Importer’s name, address, e-mail address, and telephone number. The address of the importer shall be in a Party’s territory. If the importer name and address are not known or there are multiple importing locations, you may state “Various.”

Provide a description of the good. The description should be sufficient to relate it to the good covered by the certification.

Provide the Harmonized Tariff Schedule classification to the 6-digit level for each good described in Field 6 

Specify the origin criterion (A, B, C, D, or E) under which the good qualifies, as set out in Article 4.2 (Originating Goods):

A – Wholly obtained or produced entirely in the territory of one or more of the Parties, as defined in Article 4.3 (Wholly Obtained or Produced Goods)

B – Produced entirely in the territory of one or more of the Parties using non-originating materials provided the good satisfies all applicable requirements of Annex 4-B (Product-Specific Rules of Origin)

C – Produced entirely in the territory of one or more of the Parties exclusively from originating materials

D – “Except for a good provided for in Chapter 61 to 63 of the Harmonized System:

(i) produced entirely in the territory of one or more of the Parties;

(ii) one or more of the non-originating materials provided for as parts under the Harmonized System used in the production of the good cannot satisfy the requirements set out in Annex 4-B (Product-Specific Rules of Origin) because both the good and its materials are classified in the same subheading or same heading that is not further subdivided into subheadings or, the good was imported into the territory of a Party in an unassembled or a disassembled form but was classified as an assembled good pursuant to rule 2(a) of the General Rules of Interpretation of the Harmonized System; and

(iii) the regional value content of the good, determined in accordance with Article 4.5 (Regional Value Content), is not less than 60 percent if the transaction value method is used, or not less than 50 percent if the net cost method is used”

E – The goods provided for under the tariff provisions set out in Chapter 2 – Table 2.10.1, Table 2.10.2, and Table 2.10.3.

For each good described in Field 6, where you are the Producer of the good, indicate “YES”; otherwise indicate “NO.”

For each good described in Field 6, where the good is subject to a Regional Value Content (RVC) requirement, indicate “NC” if the RVC was calculated according to the Net Cost method and “TV” if the good was calculated according to the Transaction Value method. If the good was qualified via a tariff shift, indicate “TS.” If Origin Criterion A or C, you may enter “NO.”

Identify the country of origin of the good using the ISO Country Code (e.g. “CA”, “US”, “MX”)

Include the total page count of the cover page + continuation page(s) containing eligible parts only. Non-Eligibles addendum and Instructions should NOT be part of total page count.

This field must be completed, signed, and dated by the authorized Certifier. The date must be the date the Certificate was completed and signed. Indicate Certifier’s Company, Title, Telephone Number, and Email Address.

In accordance with the United States Mexico Canada Agreement regulations, under 19 CFR 182 Appendix A, Section 9, Paragraph 2(b), indicate the amount of originating content for Not Eligible goods that last underwent production in the US, CA, or MX. This should be in a per-unit amount and be in USD. Parts of non-US, MX, CA origin can only have accumulated value if the last country in which they underwent production was the US, CA, or MX. E.g. If China origin part contains US components, but last country of production was CN, Accumulated Value would be $0. A final packaging/re-packaging operation in the US does not constitute “production.”