Shippzy Customs Declaration Form

Complete your shipment information and customs declaration online. Review your details and print a completed copy.

SECTION A — SENDER DETAILS

Full Name *

Phone Number *

Email Address *

Full Address *

City *

Province/State *

Country *

Postal/ZIP Code *

SECTION B — RECEIVER DETAILS

Full Name *

Phone Number *

Email Address *

Full Address *

City *

State/Province *

Country *

Postal/ZIP Code *

SECTION C — SHIPMENT CONTENTS

Currency

No.	Item Description	Qty	Value (CAD)	Action
1
2
3
4
5
6
TOTAL DECLARED VALUE:			CAD 0.00

SECTION D — CUSTOMER DECLARATION

I, the undersigned sender, hereby declare and confirm that:

I personally know and have verified all shipment contents listed above.
All shipment contents have been accurately and truthfully declared.
No unknown, concealed, or intentionally undeclared items are included.
The shipment does not knowingly contain prohibited, illegal, or restricted items, including illegal drugs or narcotics.
I acknowledge that shipping restrictions and customs regulations apply.
I authorize lawful inspection of the shipment by Shippzy, carriers, customs, or other authorized authorities where permitted.
I accept responsibility for the accuracy of the information provided, subject to applicable law.
I understand that customs duties, taxes, inspections, and delays may apply.

Shippzy Inc. retains its own applicable legal and regulatory responsibilities.

SECTION E — CUSTOMER SIGNATURE

I confirm that the information provided is accurate and I agree to the declaration above. *

Customer Full Name *

Date *

Signature *

SHIPPZY INC.

CUSTOMS DECLARATION FORM

140 Advance Blvd, Unit 7, Brampton, ON L6T 4Z8 | +1 (437) 616-0758

SENDER

Name:

Phone:

Email:

Address:

, ,

RECEIVER

Name:

Phone:

Email:

Address:

, ,

SHIPMENT CONTENTS

No.	Description	Qty	Value (CAD)
TOTAL:			CAD 0.00

DECLARATION

I declare that: (1) I have verified all contents; (2) All contents are accurately declared; (3) No undeclared items included; (4) No prohibited items included; (5) I authorize lawful inspection; (6) I accept responsibility for accuracy; (7) I understand customs regulations apply.

Customer Name:

Signature:

Date:

2026-10-17