U. S. Importers Declaration of Manufacturer

U. S. IMPORTERS DECLARATION OF MANUFACTURER

I, (1)______________________________, declare that: i) the articles herein specified were manufactured by the company indicated below, and they are to the best of my knowledge and belief, the growth, produce, or manufacture of the United States; ii) they were exported from the United States from the Port of (2)____________________ on or about (3)_______________, 20____; and iii) they are being returned without having been advanced in value or improved in condition by any process of manufacture or other means. I further declare that U.S. manufacturer's drawback: (4) ( ) was claimed*

(4) ( X ) was not claimed

Item, Description, Quantity & Value (5)______________________________________________________________________ ________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

COMPANY OF

MANUFACTURE: (6)_____________________________________________________

ADDRESS:

(7)______________________________________________________________________ ________________________________________________________________________

________________________________________________________________________

SIGNATURE: (8) __________________________________________

TITLE: (9) __________________________________________

DATE: (10) __________________________________________

FILED ON CUSTOMS ENTRY NO. (11)__________________________________

* If U.S. manufacturer's drawback was claimed, please indicate below the amount of

drawback received, port and date filed.

I, (12)___________________ as an employee of Lockheed Martin Aeronautics Company duly authorized by power of attorney certify the above information to be true and correct to the best of my knowledge and belief.

SIGNATURE: (13)__________________________________________

TITLE: (14) Import Compliance Coordinator

DATE: (15) __________________________________________

INSTRUCTIONS

1. Name of LM Aero person requesting return of U.S. Goods

2. Port of export to the foreign country from the U.S.

3. Date of export to the foreign country from the U.S.

4. Indicate whether drawback was claimed or not claimed (Drawback was not claimed)

5. Item description, quantity and value

6. Company of manufacture

7. Company's address

8. Signature of shipment requestor

9. Title

10. Date of signature

Items 11 thru 15 will be completed by LM Aero Import Control

11. To be completed by customs broker

12. Name of LM Aero employee authorized by power of attorney.

13. Signature.

14. Title

15. Date