NON-RESIDENT IMPORTER'S VALUATION INQUIRY NOTE This questionnaire has proven useful in assessing compliance with Canadian customs valuation laws and policies. We strongly recommend it be completed and returned to us for review as soon as possible. Importer's Responsibility The valuation system is a self-assessing program. The method of valuation to be used is the responsibility of the Importer. CERTIFICATION Please print clearly or type I, ................................................................................ of ............................................................................... (Name of Officer) (Name of Company) certify that the information declared in this document has been verified by me and found to be correct in all respects and that I will advise Affiliated Customs Brokers Limited of any change that could affect its validity in the future. Signed at.................................................................. / ................................... on ........... / ........... /............. (City) (Province) (Date) .................................................................... / ................................................................. (Signature)(Pres., V. Pres., Sec.Tres.) Prepared by 1 Affiliated® NON-RESIDENT IMPORTER’S VALUATION INQUIRY Instructions If uncertain as to the correct answer, please contact one of our Customs Advisors. All questions should be answered. 1. Conditions or Considerations Is the purchase of your goods subject to, or the price dependent on a condition or YES NO consideration which affects the price paid or payable for the goods? 2. Payments other than $ (Trade-ins) Are the goods paid for, in whole or in part, in a form other than money or a monetary YES NO instrument (i.e. bartering)? 3. Buying Commissions Is (are) the Canadian purchaser(s) paying "buying commissions" in respect of your YES NO goods? 4. Other Commissions Is (are) the Canadian purchaser(s) paying commissions other than buying YES NO commissions which are not included in the invoiced price of your goods? 5. Assists Are the following goods or services supplied directly or indirectly to your firm free of YES NO charge or at a reduced cost by a Canadian purchaser for use in connection with the production of your goods: - materials, components, parts or other goods which are incorporated in the goods; - tools, dies, moulds and other goods utilized in the production of the goods; - any materials consumed in the production of the goods; or - engineering, development work, art work, design work, plans or sketches which are undertaken elsewhere than in Canada and necessary for the production of the goods? 6. Royalties or License Fees Does (do) the Canadian purchaser(s) pay royalties or license fees related to your YES NO goods? 7. Subsequent Proceeds Does a portion of the proceeds of any subsequent resale, disposal or use of your YES NO goods accrue directly or indirectly to your firm? 8. Canadian Duties, and Brokerage Does the selling price of your products include: YES NO - Canadian import duties? YES NO - Canadian sales tax (GST)? YES NO - Our brokerage fees? YES NO - Any discounts? YES NO - Freight charges? 2 NON-RESIDENT IMPORTER’S VALUATION INQUIRY RELATIONSHIP STATUS Does your company transact business (check () only one): - Only with Canadian purchasers who are NOT RELATED to your firm; - Only with Canadian purchasers who are RELATED (see “Related Persons” definition on page 4) to your firm; or - With Canadian purchasers who are RELATED and NOT RELATED to your firm. Give the name(s) of the related Canadian purchaser(s) to whom you are selling goods that you import into Canada. (It will be assumed that all other Canadian purchasers are "not related" to your firm.) Company Name Province 3 NON-RESIDENT IMPORTER’S VALUATION INQUIRY Definition of RELATED PERSONS (Customs Act, Subsection 45 (3)) a) they are individuals connected by blood relationship, marriage, common-law partnership or adoption within the meaning of subsection 251(6) of the Income Tax Act; b) one is an officer or director of the other; c) each such person is an officer or director of the same two corporations, associations, partnerships or other organizations; d) they are partners; e) one is the employer of the other; f) they directly or indirectly control or are controlled by the same person; g) one directly or indirectly controls or is controlled by the other; h) any other person directly or indirectly owns, holds or controls five per cent or more of the outstanding voting stock or shares of each such person; or i) one directly or indirectly owns, holds or controls five per cent or more of the outstanding voting stock or shares of the other. Prepared by 4 Affiliated® CAN-Valuation-Inquiry-Non-Resident.doc REV: 2001/04/25.