A link to the Portable Document Format (PDF) of this form is provided below. The content of the form is duplicated in HTML following the PDF link.
Protected C when completed
See instructions before completing. Please print or type.
- 1. Page (number) of (number)
- 2. Appellant
- Postal code - Zip code
- 3. Mail to
- Postal code - Zip code
- 4. Date received
- 5. I am or my client is
- a producer
- an importer
- an exporter
- 6. Tax identification No.
- 7. Description - As accounted for
- 8. CBSA office
- 9. Original transaction No.
- 10. Line No.
- 11. Country of origin
- 12. Date of accounting (YYYY-MM-DD)
- 13. TRS No.
- 14. Legislative authority/criterion
All applicants must attach any other information required by Memorandum D11-3-2.
- 15. Explanation
- 16. Sample provided
- 17. To the appellant's/agent's knowledge, is the issue contained in the request currently the subject of any appeal before a customs administration, the courts or any Canadian administration tribunal or any other NAFTA country? (Yes/No) If "Yes", provide status.
- 18. Has the appellant/agent previously requested advice or a ruling on this issue (other than any ruling being appealed on this application) from the CBSA or from the customs administration of another NAFTA country? (Yes/No) If advice was requested, provide status. If ruling was received, provide copy.
- 19. Declaration – To the applicant's knowledge, the facts and circumstances described in the request and any attachments are accurate, and all information considered to be relevant to the application has been provided.
- Date (YYYY-MM-DD)
- Title of signatory
- Name of signatory (Print)
- Signature of appellant/Agent
- Telephone No.
- FAX No.
Note: All appellants/agents must attach any other information required by Memorandum D11-3-2. Legible photocopies of form B236 will be accepted. Please print or type. All fields must be completed.
Field 1: Page – Number each page, including all attachments, and indicate total.
Field 2: Appellant – State full legal name and complete business address of the producer, importer, or exporter.
Field 3: Mail to – Complete this Field when the mailing address differs from the business address shown in Field 2.
Field 4: Date received – Do not use this area. CBSA will date stamp on each request package upon receipt.
Field 5: I am/client is – Check the appropriate box(es).
Field 6: Tax identification number – Legal tax identification number is: in Canada, employer number or importer/exporter number or Business Number assigned by CBSA; in Mexico, federal taxpayer's registry number (RFC); and in the United States, employer's identification number or social security number.
Field 7: Brief description of product – Provide a brief description of each good. The description should be sufficient to relate it to the customs or commercial invoice description and to the Harmonized System (HS) description of the good.
Field 8: CBSA office – State the CBSA office where the determination rendered pursuant to section 57.01 or section 61 of the Customs Act was issued.
Field 9: Original transaction No. – List the transaction number assigned to each accounting document Form B3, for each re-determination request made.
Field 10: Line number – Indicate the line number from the original accounting document Form B3.
Field 11: Country of origin – Indicate the country or countries of origin as stated on the determination/re-determination decision under appeal.
Field 12: Date of accounting – Show the "date of accounting" as assigned to the original accounting document by CBSA.
Field 13: TRS number – Show the TRS number as stated on the determination decision under appeal.
Field 14: Legislative authority/criterion – Indicate the appropriate Customs Act legislative authority, i.e., 60(1)60(2).
Field 15: Explanation – Clearly state the reason(s) for the request, providing as much detail as is required to support it. Make reference to any previous CBSA instructions or D memoranda that are relevant. If sufficient space is not available, provide additional particulars on a separate sheet. It is the responsibility of the appellant to present a completed and supported Form B236. The absence of adequate supporting information will result in the return of Form B236.
Field 16: Sample provided – Check this Field when providing a sample to support your request.
Field 17: When the response to this Field is "Yes", describe the appeal status (e.g., the issue is under appeal before a U.S. customs administration or another CBSA regional office).
Field 18: When the response to this Field is "Yes", provide the status of the request for advice or a ruling. If a ruling has been received, provide a copy with the request for a re-determination.
Field 19: Declaration
- provide the date the request was signed;
- indicate the title of the person signing the request;
- provide the name of the person signing the request;
- signature of appellant or agent;
- telephone number of the person signing the request;
- facsimile number of the person signing the request.
- Date modified: