Return KathleenLB

CN22 - CUSTOMS DECLARATION Origin Post US Postal Service (514) 750-3288 F MID: 200793 R Kathleen Lind Berardi O 37 APPLETON RD M NEEDHAM, MA 02492-4227 Date of Mailing: 11/22/2016 Category of item: Returned Goods US POSTAGE AND FEES PAID 3 lbs First-Class Pkg Intl Svc Commercial Base Price 11/22/2016 FROM 94306 071V00991468 AES/ITN/Exemptions: Detailed Description of Contents Parka TO Qty 1 3 Weight Value HS Tariff Number (lb/oz) (US$) Country of Origin 0 0.01 Denim Kings 8575 St Laurent Montreal, QC H2P 2M9 CANADA US 3 lb 3 0 0.01 TOTAL I certify the particulars given in this customs declaration are correct. This form does not contain any undeclared dangerous article, or articles prohibited by Legislation or by postal or customs regulations. I have met all applicable export filing requirements under the federal law and regulations. Sender's signature and Date Holly Kindzierski PS Form 2976 (March 2015) 11/22/2016 LZ 191 049 825 US Do not duplicate this form without USPS Approval. This item may be opened officially.