PRO FORMA COMMERCIAL INVOICE

SHIPPER:

Name:
Address:


Phone:

SHIP TO:

Folkers & Powell
74 Prospect St
Hillsdale NY 12565
USA

Phone: 518 828 9779
UNITS
1 		COUNTRY OF MFG
U.S.A. 		DESCRIPTION OF GOODS
used wooden flute, returned to maker for repair - NO COMMERCIAL VALUE		 UNIT VALUE
$10 		SUB TOTAL
$10
TOTAL PACKAGES: 1 TOTAL VALUE: $10 TOTAL WEIGHT:

I declare that these goods: [A] were made in the U.S.A., [B] are being returned to the maker for repair, and [C] have NO COMMERCIAL VALUE FOR CUSTOMS PURPOSES.

I hereby certify that the information on this invoice is true and correct and that the contents of this shipment are as stated above. I do hereby authorize UPS International Air Service to execute any additional documents necessary for the export/import of merchandise described herein on my behalf.

Signed,

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Date:
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Folkers & Powell, Makers of Historical Flutes
http://www.baroqueflute.com