For the purpose of obtaining preferential tariff treatment for goods of the Caribbean Basin beneficiary countries, this document must be completed legibly and in full by the exporter and be in the possession of the importer at the time the CBTPA claim is made.

The producer may voluntarily complete a certificate for use by the exporter in filling out their own certificate.

Note:  The purchase of a good in the Caribbean Basin beneficiary countries does not render it originating. If the origin of the good cannot be determined, the exporter must assume that the good does not originate.

To (mm/dd/yyyy)

U.S. Customs Service

OMB 1515-0226

United States-Caribbean Basin Trade Partnership Act (CBTPA) 

CERTIFICATE OF ORIGIN

19 CFR 10.234, 10.236

See Reverse for Instructions and a list of the tariff items with which this certificate may be used.

PLEASE PRINT OR TYPE. SEE INSTRUCTIONS ON REVERSE.

3. Producer's Name and Address

1. Exporter's Name and Address

4. Importer's Name and Address

From (mm/dd/yyyy)

2b) Blanket Period

Invoice or other unique reference number

2a) Single Importation

2. COMPLETE EITHER 2a or 2b

United States Customs Service See Reverse for Instructions and a list of the tariff items with which this certificate may be used. For the purpose of obtaining preferential tariff treatment for goods of the Caribbean Basin beneficiary countries, The producer may voluntarily complete a certificate for use by the exporter in filling out their own certificate. PLEASE PRINT OR TYPE. SEE INSTRUCTIONS ON REVERSE. this document must be completed legibly and in full by the exporter and be in the possession of the importer at the time the CBTPA claim is made. Note:  The purchase of a good in the Caribbean Basin beneficiary countries does not render it originating. If the origin of the good cannot be determined, the exporter must assume that the good does not originate. 2. COMPLETE EITHER 2. A. or 2 B Form Assistant Page 1 of 3

Form Assistant
Page 1 of 3

Go to Form Assistant Page (1-3):

Any data typed after screen scrolls will not print.

Any data typed after screen scrolls will not print.

Customs Form 450 (11/00)

Customs Form 450 (11/00) United States Caribbean Basin Trade Partnership Act (C B T P A) 
CERTIFICATE OF ORIGIN 19 C F R 10.234, 10.236 O M B 1 5 1 5 - 0 2 2 6

(This is a mandatory field.)