Required that the artist, shipper or seller of the goods
complete the statement as follows:
I, hereby
declare that i am the producer, seller
or shipper of certain works of art, namely _________________________________________________________________covered
(List the works of art, detailed
description) by the annexed invoice number ____________, dated
____/___/______ , under Federal Express Awb#
_______________________: that any mosaics included are originals that any sculptures or statuary included are
the original works or models or one of the first ten (10) castings, replicas,
or reproductions made from the sculptors original work or model; and that any
etchings, engravings, woodcuts lithographs or prints made by hand-transfer
processes included in that invoice were printed by hand from hand-etched,
hand-drawn or hand-engraved plates, stones, or blocks.
_________________________________________________________
Name:
seller/shpr/artist :
_________________________________________________________
Signature:
seller/shpr/artist :
_________________________________________________________
Title :
_________________________________________________________
Company
name/firm :
Date : ____/____/________
This form must
be completed and accompany any works of art that are originals as noted above
and are eligible for entry as duty free works of art. The Shipper, seller, or
the original artist / producer of the works of art should complete the form.
The consignee must show adequate proof to customs that the seller, shipper, or
artist could not provide the needed form, before it can be, accepted
from the any source other than the shipper, seller or artist.
seller, shipper or artist from b.