UNITED STATES-MEXICO-CANADA FREE TRADE AGREEMENT (USMCA)

CERTIFICATION OF ORIGIN
Supplier Code: 25170
Request ID: 1971044

Blanket Period: (MM/DD/YYYY) Single Shipment:

From: 01/01/2023 Invoice Number:
To: 12/31/2023

Certifier's Name and Address: Exporter's Name and Address:

KUS AUTOPARTES DE MEXICO S DE R DE CV KUS AUTOPARTES DE MEXICO S DE RL DE CV
Av. Nexxus 136, Parque Industrial N exx L XXI Av. Nexxus 136, Parque Industrial Nexxus XXI
General Escobedo, Nuevo León, Mé xicous General Escobedo, Nuevo León, México.
.
Telephone: Telephone:
E-Mail Address: E-Mail Address:
Tax Identification Number: Tax Identification Number:
Producer's Name and Address: Importer's Name and Address:

Available to custom upon request Various

Telephone: Telephone:
E-Mail Address: E-Mail Address:
Tax Identification Number: Tax Identification Number:

Part Number Description Tariff Origin Certification Qualification Country of Accumulation Labor Value
of Good(s) Number Criterion Indicator Method Origin Value Content
(USD) Requirement

See Attached

I CERTIFY THAT:

* The Information on this document is true and accurate and I assume the responsibility for proving such representations. I understand that I am
liable for any false statements or material omissions made on or in connection with this document;
* I agree to maintain, and present upon request, documentation necessary to support this certification.
* The goods originated or are considered to have originated in the territory of one or more of the parties, and comply with the origin
requirements specified for those goods in the United States-Mexico-Canada Free Trade Agreement; there has been no
no further production or any other operation outside the territories of the parties, other than unloading, reloading, or any other
operation necessary to preserve the goods in good condition or to transport the goods to the territories of the parties; the goods remained under the control of the customs
authorities while in the territory of a non-party; and
* I also agree to notify any party provided with this certificate of any changes that might adversely impact a certification previously given.
*This certification consists of pages, including all attachments.

Authorized Signature: Company:

KUS AUTOPARTES DE MEXICO S DE RL DE CV

Name: Title:
LUIS ALFONSO VALDEZ GUARRIOLA LEGAL REPRESENTATIVE

Date: (MM/DD/YYYY) Email: Telephone:

8126654474
01/01/2023 Luis Valdez <mx.finanzas@kusauto.com>
 UNITED STATES-MEXICO-CANADA FREE TRADE AGREEMENT
(USMCA) 2023 CERTIFICATION OF ORIGIN CONTINUATION
PAGE(S)

upplier Code: 25170 Year: 2023

Request ID: 1971044
Tariff Origin Certification Qualification Country Accumulation Labor Value
Part Number Supplier Product Code Description of Good(s) Number Criterion Indicator Method of Origin Value Content
(USD) Requirement

4140918C91 JKA03235 DEF HEAD UNIT 842199 B D RVC MX 0 0

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