Commercial Invoice - Returned Goods Importer: PBT USA 5 Durell Drive Jackson Township, NJ 08527 USA Importer Number: N/A – Private Importer Exporter (Customer): Name: ________________________________ Address: ______________________________ ______________________________________ Description of Goods: Returned garment – Backalast Compression Posture Jacket (unchanged; no value added) Quantity: _______ HS Code: 9801.00.2600 Country of Origin: China Declared Value: $1.00 (For customs purposes only – Not a sale) Reason for Export: Return for refund/exchange Statement: Goods were not advanced in value or improved while abroad. Signature: _____________________________ Date: __________________