PROFORMA INVOICE
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DTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)1TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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TEL (HOME):Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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Date last left Japan:TEL (HOME):Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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Date last left Japan:

TEL (HOME):

Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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Date last left Japan:

TEL (HOME):Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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Date last left Japan:TEL (HOME):Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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TEL (HOME):Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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NAME:

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ADDRESS:ADDRESS:

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PREFECTURE:

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COUNTRY: CANADACOUNTRY: JAPANTEL:EMAIL ADDRESS:

Date last left Japan:

TEL (HOME):

Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLARBOX NO.

DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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Date last left Japan:TEL (HOME):Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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Date last left Japan:TEL (HOME):Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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Date arriving Japan:/YYYY

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DTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLARBOX NO.

DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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Date last left Japan:

TEL (HOME):

Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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COUNTRY: CANADACOUNTRY: JAPANTEL:EMAIL ADDRESS:

Date last left Japan:

TEL (HOME):

Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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Date last left Japan:

TEL (HOME):Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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Date last left Japan:

TEL (HOME):

Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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Date last left Japan:

TEL (HOME):

Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)PROFORMA INVOICE
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Page

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PREFECTURE:

POSTAL CODE:POSTAL CODE:

COUNTRY: CANADACOUNTRY: JAPANTEL:EMAIL ADDRESS:

Date last left Japan:

TEL (HOME):

Date arriving Japan:/YYYYMDTEL (MOBILE):*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
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DESCRIPTION OF GOODS（品目）NEW/USEDQUANTITY(数量)UNIT PRICE(単価)TOTAL VALUEGRAND TOTAL VALUE (ALL PAGE)I DECLARE THAT ALL INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECTSIGNATURE:AMOUNT(合計)送り状 右上の11桁の番号を記入ください
CWB NO. :140 5297 0724

PROFORMA INVOICETO

CITY: TORONTOPROVINCE: ON
POSTAL CODE: L4T1L2COUNTRY: CANADATEL: 416-111-2222Date last left Japan:
2019 / 11 / 29
Date arriving Japan:2021 / 1 / 15
YYYYM

Jan 2, 2021

DATE:

NAME: HIROKO UMINOADDRESS: 111 EAST AVENUE

FROM

記入例
1Page

1/NAME: HIROKO UMINOADDRESS: 3-9-2 TATSUMICITY: KOTO-KU
梱包しながら
PREFECTURE: TOKYOPOSTAL CODE: 135-8527
ご記入くださいCOUNTRY: JAPANEMAIL ADDRESS: otegaru@ocs.express
TEL (HOME): 0120-627-012
TEL (MOBILE): 090-1000-1000

D*PERSONAL EFFECTS UNACCOMPANIED BAGGAGE *NO COMMERCIAL VALUE, VALUE FOR CUSTOMS PURPOSE ONLY *CURRENCY IN CANADIAN DOLLAR
BOX NO.

DESCRIPTION OF GOODS

NEW/USEDQUANTITY

UNIT PRICEAMOUNT1COTTON LON SLEEVES SHIRTS
SPORTS SHOES
使用された品物かど
うかをご記入ください
SOCKS
CAP
LEATHER JACKET
COTTON T-SHIRTS
箱のとおし番号を
COTTON PANTS

Used
Used
Used
Used
Used
Used
Used

5251110
3

5.00
20.00
5.00
10.00
50.00
5.00
5.00

25.00
40.00
25.00
10.00
50.00
50.00
15.00

DICTIONARYTEXT BOOK
品名は具体的にごPHOTOS WITH ALBUM
記入くださいMUSIC CD
DATA CDPENCILPEN
DVD、ビデオテープはERASER
作品のタイトルまでNOTEBOOK
記載してください
RULER
DVD (TITLE: STAR WARS)FREE MAGAZINE (TORJA)

Used
Used
Used
Used
Used
Used
Used
Used
Used
New
Used

202520251511120.00
10.00
5.00
5.00
1.00
1.00
1.00
1.00
1.00
1.00
10.00
5.00

20.00
200.00
10.00
25.00
20.00
2.00
5.00
1.00
5.00
1.00
10.00
5.00

Used

1350.00

350.00

ご記入ください23

ACOUSTIC GUITAR (IN HARD CASE)

記入漏れが無いようにご注意ください

必ずお値段をご記入ください
Used
1$0 は不可です

このページの合計金額をご記入ください
お荷物全体の合計金額をご記入ください

TOTAL VALUE $869.00

GRAND TOTAL VALUE (ALL PAGE) $869.00

必ずご署名をお願いします。ご署名が無い場合、通関が出来ません。
I DECLARE THAT ALL INFORMATION CONTAINED IN THISINVOICE TO BE TRUE AND CORRECTSIGNATURE:

海野広子

2021-02-03 5:27 PM