COMMERCIAL INVOICE

COMMERCIAL INVOICE FROM:

  Name:
  Address:

DATE OF EXPORT:

AIR WAYBILL NO:

CONSIGNEE:

  Microplex Systems Ltd.
  301 2071 Kingsway Avenue 
  Port Coquitlam, BC 
  Canada, V3C 6N2

IMPORTER: (if other than consignee)

  same as consignee

COUNTRY OF ORIGIN: Canada

# of PCKGS      DESCRIPTION              QTY    TOTAL VALUE

 
REASON FOR RETURN: warranty repair

I declare all information contained in this invoice to be true and 
correct.



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SIGNATURE             NAME                  DATE