19 C.F.R. § 10.704
(a) Contents. An importer who claims preferential tariff treatment for a good under the US-JFTA must submit, at the request of the Center director, a declaration setting forth all pertinent information concerning the production or manufacture of the good. A declaration submitted to CBP under this paragraph:
(2) Must include the following information:
(3) Must include a statement, in substantially the following form:
“I certify that: The information on this document is true and accurate and I assume the responsibility for proving such representations. I understand that I am liable for any false statements or material omissions made on or in connection with this document; I agree to maintain, and present upon request, documentation necessary to support these representations; The goods comply with all the requirements for preferential tariff treatment specified for those goods in the United States-Jordan Free Trade Agreement; and This document consists of ____ pages, including all attachments.”
(d) Applicability of declaration. The declaration may be applicable to: