SINGLE COUNTRY DECLARATION
I, ………………………………………				declare that the articles listed below and covered
by the invoice or country to which this declaration relates are wholly the growth, product , or
manufacture of a single foreign territory or country, or insular possession of the U.S.,or where
assembled in the single foreign territory or country, or insular possession of the U.S. of fabri-
cated components which are in whole the product of the U.S.and/or single foreign territory
or country, or insular possession of the U.S. as identified below. I declare that the information
set forth in this declaration is correct and true to the best of my information, knowledge and
belief.
2. AWB #
3.   DESCRIPTION					4.   COUNTRY OF		5.   DATE OF
/QUANTITY /FABRIC CONTENT%					ORIGIN		EXPORTATION
					***Please note if articles are woven no.1
					below needs to be completed but if ar-
6.   DATE					ticles are knit you need to complete no.1
					through no.5
7.   NAME					12. KNIT OR WOVEN
8.   SIGNATURE					13. TYPE OF NECK TREATMENT (I.E.
					CREW, NO NECK OPENING,
					ZIPPERED OPENING, BUTTON
9.   TITLE					PLACK)
10. COMPANY					14. STICHES PER		15. LONG/SHORT
					CENTIMETER		SLEEVES
11. ADDRESS					16. TYPE OF BOTTOM