NAFTA Certificate Request

Company Information

Fields marked with an asterisk must be completed in order to save and send this form

Company Name *
Company U.S. federal tax ID number, Canada business number (BN), or Mexico numero de registro fiscal *
Street Address *
Address (cont.)
City *
State / Province *
Zip / Postal Code *
Your country *
Your Name *
Title
Business Phone *
Fax *
Email *
NAFTA calendar year for which a certificate is requested (ex. 2006) *
INEOS O&P grades to be covered under this request (ex. H00G-00 or T60-800-119) *
Any additional requests