Skip to main content

Country of Origin/USMCA Request Form

Use the list box below to copy/paste Molex part numbers (and your own part numbers) from a spreadsheet or .txt file

  Paste your list of parts here:
  Data Information:

  Requester Information:
Request Type: COO (emailed only)
Eccn (emailed only)
Hts (emailed only)
USMCA (emailed only)
Certificate Request Year:
Delimiter is: Tab  Comma
Data has header: Yes  No
Company Name:
Email Address:
Company Address 1:
Company Address 2:
City:
State:
Zip:
Country:
Contact Name:
Contact Telephone:
Contact Fax:
Additional Comments:
Are you importer of record? No Yes


  

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Instructions:

1. Copy the column of Molex part numbers from your spreadsheet (maximum of 200)*

* You can also include the customer part number (for reference) if it should be included in the completed request for up to 200 parts only. Any more than 200 parts and the customer part number cannot be included on the finished form. To do so, make sure the columns you are copying have the Molex part number on the left and your part number on the right.



2. Paste your data into the list box on the left.

3. Select the type(s) of request(s) you are making (USMCA, COO, ECCN, HTS)

4. Enter the Calendar Year for which your request should be processed.

5. Select whether or not the data you have pasted contains a header row. In the example above, you would select the 'Header row' button.

6. Hit Send Request.

Keep in mind that in order to successfully process your request a valid Molex part number is required. Upon submitting your request a confirmation screen will be displayed along with part numbers we did not recognize and could not process. Please contact your Molex representative if you need assistance with this site.
Country of Origin/NAFTA Request Form