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461NA-Revised 1959
JULIUS BLUMBERG, INC., LAW BLANK PUBLISHERS
80 EXCHANGE PLACE AT BROADWAY, NEW YORK

1959 N-A Invoice approved by Canadian Customs (1959) for goods shipped on consignment without sale by exporter prior to importation, for entry at Most Favored Nation Tariff Rates.

Place and Date  New York, November 18th, 1963
Invoice of 1 Marble Sculpture (antique work of art)
consigned by Jacques Seligmann & Co., Inc. of 5 East 57th Street, New York 22, N.Y. USA to Mr. Victor Lynch- Staunton of Clydagh, Nashville (Ont.) to be shipped from New York per Air-Express (REA Agency) 
TERMS: [[blank]] CUSTOMER'S ORDER NO [[blank]] OUR ORDER NO [[blank]]

[[6-column table]]
| Country of Origin | Marks and Numbers on Packages |
QUANTITIES AND DESCRIPTION OF GOODS | Fair Marker Value
at Time and Place of Shipment in Currency of Country of Export (See Clauses  and 9 of Certificate of Value hereon | @ | Amount |
| --- | --- | --- | --- | --- | --- |
France | 1 | One case - one inner case Marble Sculpture 15th Century representing "St. Jerome in his Study" (Fifteen Thousand US Dollars). | US/$15,000.- |

To be made in British countries before a Collector of Customs, Justice of the Peace, Notary Public or any
official authorized to administer oaths; and in other countries before a British or other Consul, Notary Public or other official authorized to administer oaths.

(N) I, (name of party subscribing to this declaration)
O. Porjes of (city or town and country) New York City, N.Y. UAA  do solemnly and truthfully declare as follows:-

1. That I am (a member of the firm of [giving name of the firm when the shipment is made by a firm], or an
officer, director or manager of [giving the name of the corporation when the shipment is made by a corporation]) Manager of Jacques Seligmann & Co., Inc. (name of consignee) the owner of the goods shipped on consignment to Mr. Victor Lynch-Staunton at Clydagh, Nashville - Ontario, Canada in Canada and described on the annexed invoice:
2. That the said invoice is a complete and true invoice
of all the goods included in this shipment;
3. That the said goods are properly described in the said invoice;
4. That there is included in the said invoice the true
value of all cartons, cases, crates, boxes and coverings of any kind and all charges and expenses incident to placing the said goods in condition packed ready for shipment to Canada;
5. That none of the said goods have been sold by or on behalf of the owner to any person, firm or corporation in Canada.
6. That the said invoice also exhibits the fair market value, at the time when and place from which the goods were shipped directly to Canada, of like goods when sold in the same or substantially the same quantities for home consumption in the ordinary course of trade under competitive condition to purchasers located at that place with whom the vendor deals at arm's length and who are at the same or substantially the same trade level as the importer; 
7. That where like goods are not sold for home 
consumption in the circumstances described in the preceding section but where the goods shown on this invoice are similar to those sold for home consumption, the fair market value exhibited thereon is not less than the aggregate of
(a) the cost of production of the goods exported; and
(b) an amount that is the same percentage of the cost
of production of the goods exported as the gross profit
on the similar goods is of the cost of production of the similar goods;
8. That the said fair market value is without
(a) any discount or deduction not shown, allowed and deducted on invoices covering sales for home consumption in the country of export in the ordinary course of trade;
(b) any deduction on account of any subsidy or drawback of Customs duty that has been allowed by the Government of any other country, or on account of any so-called royalty, rent or charge for use of any machine or goods of any description, that the seller or proprietor does or would usually charge thereon when the same are sold or leased or rented for use in the country of export; or 
(c) any discount or deduction on account of the amount of consideration or money value of any special arrangement between the exporter and the importer, or between and persons interested therein, because of the exportation or intended exportation of such goods, or the right to territorial limits or the sale or use thereof;
9. That if the fair market value of the said goods described in this invoice is other than the value thereof as above specified, such fair market value has, to the best of my knowledge and belief, been fixed and determined under the authority of the Customs Act at the value exhibited in this invoice;
(A) That each article on this invoice is bona fide the produce or manufacture of the country specified on the invoice as its Country of Origin.
That each manufactured article on the invoice in its present form ready for export to Canada has been finished in such specified country of origin, and not less than one-half the cost of production of each such article has been produced through the industry of* France (insert here name of country or countries)
entitled to the benefits of treaty or convention rates or the British Preferential Tariff. 
Declared at New York, New York }
this 18th day of November 1963, 19 }
before me [[blank]] (A Commissioner, etc.) } (Signature) [[blank]]
Public
NOTE.-When invoicing goods which have been finished in a country specified on the invoice as its country of origin from materials originating in a country or countries entitled to the benefits of the Most Favored Nation Tariff of the British Preferential Tariff, the names of the countries contributing to one-half the cost of production should be shown in the space provided in the certificate. 
In the calculation of the cost of production for the purpose of determining the qualification for entry under the Most Favoured Nation Tariff none of the following items are to be included or considered, viz:-
1. Outside packages and expenses of packing thereinto.
2. Manufacturer's or exporter's profit of the profit remuneration of any trader, broker, or other person dealing in the article in its finished manufactured condition.
3. Royalties.
4. Customs or excise duty or tax paid or payable on imported materials. 
5. Carriage, insurance, etc., from place of production or manufacture to port of shipment.
6. Any other charges incurred or to be incurred subsequent to the completion of the manufacture of the goods.
In cases where the vendor does not reside in the country of export or for other reasons the vendor is unable to sign the certificate both as to value and origin, a separate certificate of origin in prescribed form signed by the exporter in the country of export, bearing a full description of the goods and the marks and numbers of the packages, so that it may be identified with the shipment, will be accepted.