Date: <1> Customer Name: Address 1: Address 2: City/St/Postal Code/Country: Phone: Fax: Contact SHIPPER: Name: Address: City/St/Postal Code/Country: Phone: Fax: Contact: When:
COMMERCIAL INVOICE
Page 1 of Invoice #: <2> RA #: Air Waybill Number:
CONSIGNEE: Name: Aseptico, Inc. Address: 8333 216th Street SE City/St/Postal Code/Country: Woodinville, WA 98072 USA Phone: 425.487.3157 Fax: 360.668.8722 Contact: Customer Service Department When: 8:00 AM to 4:30 PM PST
<3> BROKERAGE FIRM: Name: Address: City/St/Postal Code/Country: Phone: Fax:
All shipments must be sent prepaid
<4> Commodity Description (model, SN#)
Qty
<5> Country of Manufacture
Weight
Total Value (USD)
Name: Title:
Date:
I declare all the information contained in this invoice to be true and correct
Signature of shipper/exporter (type name and title and sign)
Guidelines for Completing the Commercial Invoice The Commercial Invoice is your communication with Customs authorities to declare the articles you are shipping and their value. This template and these instructions are provided to you as a courtesy to facilitate your return shipment. For more information or country-specific export requirements, please contact your shipper or customs agent. The Commercial Invoice should be printed on your company letterhead; prepare 4 signed original copies. Customs authorities reserve the right to require additional documents and information. Note: * All values must be stated in USD. * All shipping, export and import costs must be prepaid. Any costs resulting from shipments received and accepted freight collect will be invoiced to you by Aseptico. Any customs duties incurred as a result of incorrect harmonized codes will be invoiced to you by Aseptico. 1. Shipper / Exporter: Provide contact name, company name, and full address. 2. Return Authorization * All shipments must include the RA number issued by Aseptico’s Customer Service Department. * Per Aseptico’s return policy, Aseptico reserves the right to refuse delivery of packages not marked with an RA #. 3. Brokerage Firm: If the shipment will be handled by an importer who is not the recipient, add the full name and address here. Aseptico’s Brokerage Agent is: Robert E. Landweer & Co., Inc. th 15111 8 Avenue SW, Suite 301 Seattle, WA 98166 Phone: 206.623.5335 Fax: 206.343.9253 FedEx and UPS can also provide brokerage services. 4. Commodity description of each item must include: Full description including: Harmonized code For Aseptico manufactured products: 9801.00.10.12 For Anthogyr handpieces: 9818.49.80.40 For NSK handpieces 9818.49.80.40 For Bien Air handpieces 9818.49.80.40 For KaVo handpieces 9801.00.10.12 Reason for export/intended use (i.e.: for repair by manufacturer) Part or serial number(s)
5. Country of Manufacture: The country in which each of the commodities in your shipment was originally manufactured or produced. Item Country of Origin For Aseptico manufactured products: USA For Anthogyr handpieces: France For NSK handpieces Japan For Bien Air handpieces Switzerland For KaVo handpieces USA Note: Some handpieces require special shipping instructions. These instructions will be sent to you when you contact Aseptico’s Customer Service Department for your RA number.
6. Before you sign the Declaration Ensure that all the information is consistent with the Air Waybill or your shipment could be delayed in customs. Certain commodities may need extra documentation or export licenses. Most transactions require one original commercial invoice with three copies. We also recommend that you put a copy inside the package. For details on any country-specific Commercial Invoice requirements, contact your shipping company or broker.