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Canada Export Declaration
 

Create Canada Export Declaration

This form is for international shipments.

Canadian Exporter
Name  
Company:  
Street and No:  
City:  
Country/Territory:  
Province/State:  
Postal Code:    

Consignee Name and Complete Address
Name:  
Street and No:  
City:  
Country/Territory:  
Province/State:
Postal Code:

Shipment Information
Business Number:   Left nine digits  
RM Extension:   Right four digits  
Exporter Reference Number:
Transport Document Number:
Date Of Export:
Country of Final Destination:  
Export Permit Number:
Name of Exporting Carrier:
Vessel Name if Marine:
Currency of Declared Value:  
Place of Exit:
Freight Charges to Point of Exit:
Mode of Transport from Point of Exit:
Other Mode of Transport (if applicable):
Conveyance Number:
Containerized:
Reason for Export (if goods not sold):

If additional item space is necessary to complete this form, please enter the number below:
Number of additional items:

Description
Province of
Origin
Country of
Origin
Item
Description
HS
Commodity
Code
Quantity Quantity
Unit Of
Measure
Value F.O.B.
Point of Exit
               

Gross Weight:    
Package Count: 
Package Type: 
Package Container Number: 

Service Provider Information
Name:
Street and No:
City:
Country/Territory:
Province/State:
Postal Code:
Telephone: Digits only

Person Responsible for Completion
Name:  
Company:  
Street and No:  
City:  
Province/State:  
Postal Code:    
Telephone:     Digits only
Status:  


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