Cotton Woven Fabric (85% or more by weight cotton) Purchased in Calendar Year 2000 and Used in the Domestic Cutting and Sewing of Men's and Boys' Shirts

OMB No: 0625-XXXX

Expires: xx/xx/xx

AFFIDAVIT FOR APPLICATION FOR TRQ LICENSE

COTTON SHIRTING FABRIC

TARIFF RATE QUOTA

2007

If data provided is to be treated as Business Confidential, please indicate prominently across top of form

Company Name: _______________________ Contact Name: ______________________

Company Address: _______________________ Contact Address: ______________________

_______________________ ______________________

_______________________ ______________________

Company Federal Tax Contact Telephone Number: ________________

Identification Number: _______________________ Contact Fax Number: ________________

Contact E-mail Address ________________

Please check if men’s and boys’ cotton woven shirts are cut and sewn in the United States in Calendar Year 2007.

and/or

Please check box if men’s and boys’ cotton woven shirts were cut and sewn by a contractor in 2007 and you had title to the fabric.

Quantity of imported woven fabrics of cotton containing 85 percent or more by weight of cotton purchased during calendar year 2000 for use in the cutting and sewing of men’s and boys’ cotton shirts in the United States.

______________________Square Meters.

Date of Purchase:

(a) the invoice date if the manufacturer is not the importer of record.______________________________________

_______________________________________________________________________________________________

(b) the date of entry if the manufacturer is the importer of record._________________________________________

_______________________________________________________________________________________________

Manufacturing facilities producing men’s and boy’s shirts of cotton containing 85 percent or more by weight of cotton during calendar year 2000.

Names and Address of Plant Producing
Contractors and Location of Plants

For listing additional plants and/or contractors, add additional pages.

Certification Statement: I, the duly authorized representative, as an employee, officer or agent, with personal knowledge of the matters set out in the application, certify that the information contained therein is complete and accurate, signed and sworn before a Notary Public, and acknowledging that generally, pursuant to 31 U.S.C. 3729 persons providing false or fraudulent claims, and pursuant to 18 U.S.C. 101, persons making materially false statement to representations, are subject to civil or criminal penalties, respectively.

Signature of Representative Date

Signature of Notary Date

Public reporting for this collection of information is estimated to average 1 hours per response, including the time for reviewing instructions, and completing and reviewing the collection of information. All responses to this collection of information are voluntary, and will be provided confidentiality to the extent allowed under the Freedom of Information Act. Not withstanding any other provision of the law, no person is required to respond to nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless the collection of information displays a current valid OMB control Number. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Clearance officer, International Trade Administration, Department of Commerce, Room 4001, 14^th and Constitution Avenue, N.W., Washington, DC 20230.