B238 – NAFTA Verification of Origin Questionnaire

A link to the Portable Document Format (PDF) of this form is provided below. The content of the form is duplicated in HTML following the PDF link.

Protected C when completed

This questionnaire is sent to you pursuant to Article 506 (1)(a) of the North American Free Trade Agreement (NAFTA). The questionnaire will be used in determining if the (good) described on the NAFTA Certificate of Origin (CO) dated (date)and signed by (name) originates under the NAFTA. If necessary, additional information may be requested at a later date.

• Exporter – If this box is checked, you are being sent this questionnaire as the exporter of the imported good. If you relied upon a Certificate of Origin or written representation from the Producer to prepare your Certificate of Origin, provide a copy of what it was that you relied upon, and then go directly to Section V and complete it. If you relied upon your knowledge of the good, complete the questionnaire.
• Producer of good – If this box is checked, you are being sent this questionnaire as the producer of the imported good. The good was exported by (name). Complete the questionnaire.
• Exporter/Producer – If this box is checked, you are being sent this questionnaire as the exporter and also the producer of the imported good. Complete the questionnaire.
• Producer of material – If this box is checked, you are being sent this questionnaire because (name) identified you as the producer of the material(s) used in the production of the good described above. Complete the questionnaire.

You have until (date) to return the completed and signed questionnaire to the requesting Canada Border Services Agency (CBSA) office. You may fax your response. If a reply cannot be made by this date, please contact the CBSA office by mail, telephone, or by fax. If additional space is needed for your response, attach additional pages as needed. When the verification is completed, the exporter/producer will receive a written determination of the findings (NAFTA Article 506). The producer of a verified material will also be notified of the results of the verification of the material. The CBSA, shall in accordance with Article 507 of the NAFTA and section 107 of the Customs Act, protect the confidentiality of all business information submitted and shall not, with the exception of the United States Bureau of Customs and Border Protection (CBP) of the United States, disclose such information to a third party without prior approval from your company. Pursuant to the Memorandum of Understanding Regarding the Exchange of NAFTA Related Information, the CBSA will share the results of this verification with the CBP. The questionnaire must be signed and dated by an individual who can certify as to the accuracy of the information provided in the questionnaire. Failure to complete and return this questionnaire may result in the denial of preferential treatment under the NAFTA.

• Section I – Production Process
  • Provide a brief description of the production process for the good/material being verified.
  • Provide the following information for each non-originating (non-originating means a material or component which does not qualify under Chapter 4 of NAFTA Rules of Origin) material or component and for each material or component whose origin is unknown, used to produce the good being verified. If none were used, state NONE.
    • Description of the material or component
    • Harmonized System Number ( Provide the six digit Harmonized System number or if the rule of origin of the good requires eight digits, supply eight.)
    • Provide the following information for each originating ("originating" means a material or component which does qualify under Chapter 4 of NAFTA Rules of Origin) material or component used to produce the good being verified. If none were used, state NONE.
      • Description of the material or component (If the material or component is self-produced (self-produced material or component is a material or component that is produced by the producer of a good and used in the production of that good (NAFTA Article 415)) and designated as an intermediate material, (intermediate material is a self-produced material or component, designated by the producer, that meets the rules of origin of NAFTA Article 401 and that is incorporated into the final good (NAFTA Article 402(10) and (11)) place the letter "D" before the name of the material or component in the table. If the material or component is self-produced but not designated as an intermediate material, then each material used in the production of this self-produced material or component must be identified separately.)
      • Basis of Originating Status (Describe type of information (i.e., certificate of origin, affidavit etc.) which was relied upon to determine the originating status of the material or component.)
      • Name and Address of the Supplier or, if known, Name and Address of the Manufacturer
      • 1. Has a classification ruling been issued with respect to any of the materials or components produced? (Yes/No) If yes, produce a copy of the ruling.
      • 2. Was the de minimis provision (NAFTA Article 405) used to determine whether the good being verified was originating? (Yes/No)
      • 3. Is the good being verified an originating fungible good under NAFTA Article 406? (Yes/No) If yes, check below which inventory management method you used:
        • LIFO
        • FIFO
        • Average
        • Specific Identification
        • LIFO
        • FIFO
        • Average
        • Specific Identification
        • Transaction Value
        • Net Cost
        • I certify that the information on this document is true and accurate and I assume the responsibility for proving such representations. I understand that I am liable for any false statements or relevant omissions made on or in connection with this document.
        • Name (Print or Type)
        • Title (Print or Type)
        • Telephone Number
        • Company Name (Print or Type)
        • Date (DD/MM/YY)
        • Authorized Signature