B2G - CBSA Informal Adjustment Request

Part A - Importer Information

1. Contact information

• Name
• No.
• Street
• Unit No.
• City
• Province
• Postal Code

2. Telephone number (xxx-xxx-xxxx)

Email address

3. Accounting document number (attach the accounting document)

4. Date of importation (YYYY-MM-DD)

5. Description and quantity of goods

6. Reason for refund/adjustment request (attach supporting documentation)

1. Goods returned to sender/exporter
2. Incorrect value should be:
3. Goods classified or described incorrectly
   should be:
4. Other (specify)

7. Please provide a brief explanation of your request.

8.Declaration

I declare that the information on this document is true, accurate and complete.

I have included supporting documentation to justify my claim.

Signature
Date

Part B - CBSA use only

11. Date received

12. Adjustment No.

13. Request approved (Yes / No)

14. Legislative Authority

15. Authorized By

16. Decision date

The information you provide in this document is collected under the authority of section 17, 32, 74 or 76 of the Customs Act, and section 96 of the Special Import Measures Act for the purpose of collecting trade data and assessing duties and taxes on imported commercial goods. The information collected may be disclosed to Statistics Canada for the purposes of Import reporting data, and to the Canada Revenue Agency for the purposes of Business Number and Import / Export accounts. If the required information is not provided, it will result in your declaration or adjustment request not being processed by the CBSA.

Under the Privacy Act, individuals have the right to access and make corrections to their personal information. The information collected is described within the Information about Programs and Information Holdings (previously Info source) under the Accounts receivable ledger Personal Information Bank CBSA PPU 1501, which is detailed within the Information about Programs and Information Holdings (formerly Info Source). Should you have concerns about the CBSA's handling of your personal information, you have a right to file a complaint with the Privacy Commissioner of Canada..

Instructions

Part A — Contact information

Field 1: Provide the importer's full name and address.

Field 2: Provide your telephone number and email so that the CBSA may contact you, if necessary, for further information.

Field 3: Provide the unique identification number found on your CBSA accounting document. Accounting documents include; BSF715 for goods carried across the border; E14 for goods received via mail; a courier receipt or the Commercial accounting document (CAD) for goods received via courier. A copy of the accounting document must be attached to this form.

Field 4: Provide the date of importation of the goods.

Field 5: Provide the quantity and a description of the goods.

Field 6: Check the box matching the reason for your refund/adjustment request. Your reason determines the supporting documents to include with your request form. All supporting documents must be legible. For information on what documentation is required, consult the: Request a refund or adjustment of duties and taxes on your goods from outside Canada - What you need to support your claim section on the CBSA website at https://www.cbsa-asfc.gc.ca/import/courier/crp-prio-eng.html

For goods classified or described incorrectly, provide the correct description of the goods on the line provided and if known, indicate the correct classification number.

If you are requesting a refund for another reason, specify the reason (i. e. goods short-shipped, goods damaged prior to release).

Field 7: Provide a brief explanation of your request.

Field 8: Sign and date the request form. Secure digital signatures are accepted.

Once completed, attach the required supporting documents and mail to the CBSA Casual Refund Center (addresses below) that coincides with the first letter of your postal code.

For the casual refund or adjustment to be acceptable, the legislative and policy requirements must be met as outlined in the Customs Act, the Refund of Duties Regulations and the Memorandum D6-2-6, Refund of Duties and taxes on Non-commercial importations.

Mail this request to the CBSA Casual Refund Centre (addresses below) that coincides with the first letter of your postal code. If your address is outside of Canada, the claim should be sent to the Scarborough Casual Refund Centre.

A-B-C-E
CBSA Casual Refund Centre
P.O. Box 430
Yarmouth NS B5A 4B3

G-H-J-K
CBSA Casual Refund Centre
1454-555 McArthur Street
Montréal QC H4T 1T4

L-M-N
CBSA Casual Refund Centre
7th floor - Suite 718, 55 Town Centre Court
Scarborough ON M1P 4X4

P-R-S-T-X
CBSA Casual Refund Centre
Unit 14 Terminal 2, 101-2019 Sargent Ave.
Winnipeg MB R3H 0Z7

V-Y
CBSA Casual Refund Centre
300 - 5940 Ferguson Road
Richmond BC V7B 0B4

Date modified:

2026-02-03