Comprehensive Harmonized System Classification & Trade Agreement Duty Exemption Claim Form

1. Section 1: Importer/Exporter & Shipment Tracking Details

Provide complete identification and tracking information for all parties involved in this international transaction. All fields marked mandatory must be completed to ensure proper customs processing.


What is your role in this transaction?


Legal Entity Name (Full Registered Name)

Business Registration/Tax Identification Number

Registered Business Address

Primary Contact Person Full Name

Contact Email Address

Contact Telephone Number (Include Country Code)


Shipment Identification & Logistics Details


Master Bill of Lading/Air Waybill Number

House Bill of Lading/Tracking Number (if applicable)

Estimated Arrival Date/Time at Destination Port

Actual Departure Date/Time from Origin Port

Mode of Transport


Vessel/Vehicle Name & Voyage Number (if applicable)

Port/Airport of Loading (Origin)

Port/Airport of Discharge (Destination)

IncoTerms 2020 Rule Applicable to This Shipment

Is this a consolidated shipment containing multiple suppliers' goods?


Container/Package Details

Container Number/Package ID

Type (e.g., 40'HC, Pallet, Carton)

Total Packages in Container

Gross Weight (kg)

Cubic Measurement (CBM)

Seal Number

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

2. Section 2: Product Description & Technical Material Breakdown

Provide exhaustive technical and commercial details for accurate customs valuation and classification. Incomplete descriptions may result in shipment delays or penalties.


Complete Commercial Product Description (as appears on commercial invoice)

Detailed Technical Specification & Engineering Description

Brand Name or Manufacturer's Name

Model Number/SKU/Part Number

Material Composition Breakdown by Percentage Value

Material Name

Harmonized System Chapter (e.g., Chapter 39 for plastics)

Percentage by Weight (%)

Material Cost per Unit

Country of Origin for This Material

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Describe the Manufacturing Process & Value-Added Operations Performed

Intended End-Use or Final Application of Product

Which of the following product categories apply? (Select all that apply)

Does this product contain any controlled/restricted substances or materials?


Commercial Value & Quantity Declaration

Invoice Line Item Number

Quantity

Unit of Measure (e.g., pcs, kg, liters)

Unit Price

Total Line Value

Currency Code (ISO 4217)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Packaging Description & Materials Used

Is the packaging treated wood or plant material requiring phytosanitary certification?


3. Section 3: Assigned HS Code & Country of Origin Justification

Accurate HS classification and origin determination are critical for correct duty assessment. Provide detailed justification supported by legal notes and explanatory guidelines.


Proposed Harmonized System (HS) Code (6-digit minimum, 8-10 digit preferred)

Have you consulted the official HS Explanatory Notes for this classification?


What is the primary basis for your HS code classification?


Detailed Classification Rationale: Explain how the product meets the terms of the selected HS heading/subheading

Is there any potential ambiguity or alternative HS classification that could apply?


Country of Origin Determination


Declared Country of Origin (Non-Preferential)

Basis for Country of Origin Determination

Did the product undergo processing/transformation in more than one country?


Explain how the product satisfies the substantial transformation criteria or specific processing rule:

Are you claiming preferential origin under any trade agreement?


Upload Supporting Technical Documentation (Product datasheets, engineering drawings, material safety data sheets)

Choose a file or drop it here
 

Classification Confidence & Risk Assessment

Very Low

Low

Medium

High

Very High

Confidence level that HS code is correct

Confidence level that origin determination is correct

Risk of customs challenge based on complexity

Availability of binding ruling for similar products

4. Section 4: Free Trade Agreement & Duty Exemption Assessment

Complete this section only if claiming duty exemption or reduction under a Free Trade Agreement (FTA) or special trade program. Incomplete FTA claims may result in denial of preferential treatment.


Are you claiming preferential tariff treatment under a Free Trade Agreement?


Specific FTA/Program Name and Version

Do you hold a valid Certificate of Origin for this product under the claimed FTA?



Rules of Origin Compliance Verification


Origin Criterion Fulfillment Matrix

FTA Rule of Origin Criterion

Applicable Rule (e.g., CTH, RVC, SP)

Calculated Value/Percentage

Threshold Requirement

Compliant?

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Does the product contain non-originating materials that exceed de minimis thresholds?


Are you applying cumulation provisions with other FTA partner countries?


What is the basis for your duty exemption/reduction calculation?

Duty & Tax Calculation Summary

Duty Type

Customs Value (CIF)

MHS Rate (%)

Preferential Rate (%)

Duty Payable (Preferential)

Duty Savings Claimed

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Are you claiming any additional exemptions (e.g., goods for processing, repair, scientific research)?


Upload Supplier's Declaration of Origin (if required by FTA)

Choose a file or drop it here
 

I confirm that I have verified the exporter's statement on origin and have reasonable proof that the product meets all FTA requirements

5. Section 5: Customs Brokerage & Compliance Officer Sign-Off

Final verification and certification by authorized customs compliance personnel. This section ensures accountability and establishes the basis for reasonable care in customs matters.


Are you using a licensed customs broker to file this declaration?


Customs Brokerage Firm Name (if applicable)

Broker Contact Person

Broker Reference Number


Compliance Verification Checklist


Overall Compliance Risk Level for This Declaration

Describe any identified compliance gaps and mitigation measures taken:

Has a binding ruling been requested or obtained for this or similar products?


Supporting Documents Checklist & Verification

Document Type

Attached

Document Reference Number

Issue Date

Issuing Authority

Commercial Invoice
INV-2024-001
1/15/2024
Exporter
Packing List
PL-2024-001
1/15/2024
Exporter
Bill of Lading
MBL-123456
1/16/2024
Carrier
Certificate of Origin
 
 
 
Technical Data Sheet
TDS-8471
11/20/2023
Manufacturer
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Authorized Signatory Certification


Full Name of Compliance Officer/Authorized Signatory

Job Title

Employee ID or License Number

Certification Date/Time

Digital Signature of Authorized Officer

I certify under penalty of perjury that the information provided is true and accurate to the best of my knowledge and that reasonable care has been exercised in verifying all details

I acknowledge that misdeclaration may result in penalties, seizure of goods, and revocation of trade privileges

Has this shipment been selected for customs audit or inspection?


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