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Statement Non Reimbursement  Form

Statement Non Reimbursement Form

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For the payment or for the reimbursement by the Manufacturer, Producer, Seller or Exporter of all or any part of the antidumping duties upon all shipments of: Commodities:_________________________________________________________________ Countries of Origin:_____________________________________________________________ Which have been and/or will be imported by this company. Time Period: From:______________________ To:___________________________ I further certify that the U.S. Customs and...
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