SPECIAL CUSTOMS INVOICE美国海关发票

(Useseparateinvoiceforpurchasedandnon-purchasedgoods)FormApproved.O.M.B.No.48-RC342SPECIALCUSTOMSINVOICEDEPARTMENTOFTHETREASURYUNITEDSTATESCUSTOMSSERVICE19U.S.C.1481.1482.14841.SELLER2.DOCUMENTNR.3.INVOICENR.ANDDATE4.REFERENCES5.CONSIGNEE6.BUYER(ifotherthanconsignee)7.ORIGINOFGOODS8.NOTIFYPARTY9.TERNSOFSALEPAYMENTANDDISCOUNT10.ADDITIONALTRANSPORTATIONINFORMATION11.CURRENCYUSED12.EXCH.RATE(iffixedoragreed)13.DATEORDERACCEPTED14.MARKSANDNUMBERSONSHIPPINGPACKAGES15NUMBEROFPACKAGES16.FULLDESCRIPTIONOFGOODS17QUANTITYUNITPRICE20INVOICETOTALS18.HOMEMARKET19.INVOICE21.Iftheproductionofthesegoodsinvolvedfurnishingorservicestotheseller(e.g.,assistssuchasdies.molds,tools,engineeringwork)andthevalueisnotincludedintheinvoiceprice,checkbox(21)andexplainbelow.□22.PACKINGCOSTS27．DECLARATIONOFSELLER/SHIPPER(ORAGENT)23.OCEANORINTERNATIONALFREIGHTIdeclare:Ifthereareanyrebates,Drawbacksorbounties□allowedupontheexportationofgoods,Ihavecheckedbox(A)anditemizedseparatelybelow.Ifurtherdeclarethatthereisnootherinvoicedifferingfromthisone(unlessotherwisedescribedbelow)andthatallstatementscontainedinthisinvoiceanddeclarationaretrueandcorrect.(B)□Ifthegoodswerenotsoldoragreedtobesold.Ihavecheckedbox(B)andhaveindicatedincolumn19thepriceIwouldbewillingtoreceive.(C)SIGNATUREOFSELLER/SHIPPER(ORAGENT):24.DOMESTICFREIGHTCHARGES25.INSURANCECOSTS26.OTHERCOSTS(SpecifyBelow)28.THISSPECEFORCONTINUINGANSWERTHISFORMOFINVOICEREQIREDGENERALLYIFRATEOFDUTYBASESUPONORREGULATEDBYVALUEOFGOODSANDPURCHASEPRICEORVALUEOFSHIPMENTEXCEEDS$500.OTHERWISEUSECOMMERCIALINVOICE.*NotnecessaryforU.S.CustomspurposesCustomsForm5515(12-20-76)