4/18/2020 (auto date inserted)
Dear Southco Supplier,
As you are probably aware, under the North American Free Trade Agreement (NAFTA), products manufactured or sold by our company can be imported to Canada and Mexico at lower duty rates if our products satisfy the country of origin requirements of that Agreement.
Your organization supplies Southco Inc. with parts, components or raw materials that are used in the manufacturing process and/or supplied to us as finished goods or parts which we resell. The Canadian and Mexican governments require that we obtain certificates of origin for parts and finished goods from designated Southco Inc. suppliers in order to determine eligibility of our products under NAFTA.
Please return the completed Manufacturer’s Affidavit “Appendix A” scm@southco.com, or by regular mail to P.O. Box 0116, Concordville, PA 19331.
It must be completed and executed by an authorized representative of your company. Please add any new part numbers to the certificate. We have taken the liberty of listing the part numbers of components or raw materials that have been or will be purchased from your organization. Please take a moment to review this list, correcting any inaccuracies you may discover. You can assign the Harmonized Tariff Code (HTS) numbers if known. The
Country of Origin (CO) all the items are required. Also, identify whether you are the manufacturer or not, Yes or
No.
If you have any questions, the US Customs Service has established a website, www.tradeinfo.doc.gov
– NAFTA
Information, to assist companies technically with regard to U.S. Customs laws and NAFTA, as they relate to goods imported into the United States. Please feel free to also contact me with any questions you may have.
Thank you for your immediate attention to this matter.
Sincerely,
Delesha Blackwell
Delesha Blackwell
Customs Compliance, Logistics and Supply Chain
Phone: (610) 361-6343
E-mail: dblackwell@southco.com
Form 0844 – rev C
18-DEC-2015
Process Owner: Manager, Corporate Supply Chain/Logistics Manager 1

APPENDIX “A”
MANUFACTURER’S AFFIDAVIT
1 ST January 2013 – 31 st December 2013
Southco
Supplier Name
Southco
Supplier ID
Southco
Item Number
Description Mfgr
Y / N
Country of
Origin
HTS Number
CERTIFICATION
I CERTIFY THAT:
1 The information on this document is true and accurate
2 I agree to maintain, and present upon request, documentation necessary to support this certification.
3 I will notify Southco, Inc., immediately of any changes in the manufacture/purchase of these goods.
SIGNATURE:
Name
Signature
Title
Date
Phone
Fax
E-mail
Form 0844 – rev C
18-DEC-2015
Process Owner: Manager, Corporate Supply Chain/Logistics Manager 2

APPENDIX “A”
Southco
Supplier Name
Southco
Supplier ID
Southco
Item Number
Form 0844 – rev C
18-DEC-2015
Process Owner: Manager, Corporate Supply Chain/Logistics Manager
Description Mfgr
Y /
Country of
HTS Number
3

REVISION HISTORY
CERTIFICATION
I CERTIFY THAT:
1 The information on this document is true and accurate
2 I agree to maintain, and present upon request, documentation necessary to support this certification.
3 I will notify Southco, Inc., immediately of any changes in the manufacture/purchase of these goods.
SIGNATURE:
Name
Signature
Title
Date
Phone
Fax
E-mail
A
B
C
21Aug13 Revised Letter for Fax and verbiage
20Mar14 Revised Letter for Email Update and automatic date inserted
18Dec15 Revised Letter for Name and Email Update
Form 0844 – rev C
18-DEC-2015
Process Owner: Manager, Corporate Supply Chain/Logistics Manager 4