Sold in the State / Province of
The undersigned manufacturer hereby certies that the new pedal boat
described below, the property of said manufacturer, has been transferred
on this day of ,
on invoice number
to
MANUFACTURER’S DECLARATION OF ORIGIN
The manufacturer further certies that this was the rst transfer of said new pedal boat in ordinary trade and commerce,
and that all information given herein is true and accurate to the best of its knowledge.
NAME OF MANUFACTURER
Pelican International Inc.
1000 Place Paul-Kane
Laval QC H7C 2T2 Canada
PEDAL BOAT DESCRIPTION
SERIAL NUMBER (ZEP):
MODEL YEAR:
MODEL NAME:
LENGTH:
DEALER NAME:
ADDRESS:
CITY:
STATE/PROVINCE:
ZIP/POSTAL CODE:
7
AUTHORIZED BY
Danick Lavoie, President
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