# Domestic Origin Supplier Affidavit Template

> Source: https://netray.co/tools/domestic-origin-supplier-affidavit-template
> Publisher: Netray (netray.co), AI and integration engineering for ERP and manufacturing systems.
> Section: Free Tools

## Short answer

A fill-in declaration a supplier signs to state country of manufacture and the share of domestic content for listed part numbers.

## Category

compliance-legal

## Region

United States

## Industry

Aerospace and Defense

## Audience

- Supplier quality
- Purchasing
- Contracts manager

## Tool

**Kind:** template

**Output:** document

**Fields:**

#### Buyer company

**Key:** buyer

**Type:** text

**Default:** Lone Star Precision Machining LLC

#### Supplier company

**Key:** supplier

**Type:** text

**Default:** Midwest Forge and Casting Co.

#### Supplier address

**Key:** supplier_address

**Type:** text

**Default:** 88 Foundry Road, Dayton, OH 45402, USA

#### Purchase order or contract number

**Key:** po

**Type:** text

**Default:** PO-77412

#### Part number

**Key:** part_no

**Type:** text

**Default:** FRG-2201-B

#### Part description

**Key:** description

**Type:** text

**Default:** Forged steel flange, 4140 alloy

#### Country of final manufacture

**Key:** country

**Type:** text

**Default:** United States

#### Domestic content percent of component cost

**Key:** domestic_pct

**Type:** number

**Default:** 78

#### Country of origin of raw material

**Key:** material_origin

**Type:** text

**Default:** United States

#### Basis of calculation

**Key:** basis

**Type:** textarea

**Default:** Cost of domestic materials, labor and overhead divided by total component cost per supplier cost accounting records, trailing 12 months.

#### Authorized representative and title

**Key:** signer

**Type:** text

**Default:** Chris Meyer, VP Operations

#### Date

**Key:** date

**Type:** date

**Default:** 2026-10-20

**Blocks:**

#### Supplier Declaration of Country of Origin and Domestic Content

**Body:** Buyer: {{buyer}}
Supplier: {{supplier}}
Address: {{supplier_address}}
Reference: {{po}}

#### Parts covered

**Table:**

**Columns:**

- Part number
- Description
- Country of final manufacture
- Raw material origin
- Domestic content %

**Rows:**

**0:** {{part_no}}

**1:** {{description}}

**2:** {{country}}

**3:** {{material_origin}}

**4:** {{domestic_pct}}

#### Basis of calculation

**Body:** {{basis}}

#### Statement

**Body:** The undersigned declares on behalf of {{supplier}} that the information above is true and complete to the best of the supplier's knowledge, that supporting records are available for review, and that the supplier will notify {{buyer}} in writing if the origin or domestic content of the listed parts changes.

#### Signature

**Body:** Name and title: {{signer}}
Date: {{date}}

**Signatures:**

- Authorized supplier representative
- Buyer receiving inspector

**Notes:** This is a starting point, not legal advice. Domestic content tests under the Buy American Act, Trade Agreements Act, FTC Made in USA rules and customer flow-down clauses use different definitions. Use the definition in your contract. Notarization is optional unless your customer requires an affidavit.

## Content

**Intro:** Prime contractors and OEMs often ask suppliers to document where a part is made and how much of it is domestic. This template gives suppliers a consistent declaration and gives buyers a record to keep with the purchase order and item master.

**Sections:**

#### How to use the template

**Body:** Enter the buyer, supplier, purchase order and each part number, with the country of final manufacture, raw material origin and domestic content percent. Describe how the percent was calculated so the claim is auditable. The supplier's authorized representative signs and dates the document, and the buyer files it with the receiving record. Re-issue the declaration when the source of material or the manufacturing site changes.

**Bullets:**

- One declaration per supplier and purchase order, or per annual agreement
- Define domestic content the way your contract does
- Store the signed copy against the vendor item in the ERP

#### Why the definition matters

**Body:** Several rules treat origin differently. Under the Buy American Act, a manufactured end product is generally domestic if made in the US and the cost of its domestic components exceeds a threshold share of the cost of all components, a threshold that has stepped up over time. The Trade Agreements Act uses substantial transformation. The FTC Made in USA standard is stricter for unqualified claims, requiring all or virtually all of the product to be made in the US. This template records the facts, and you apply the right test.

#### Worked example

**Body:** A forging supplier states that a 4140 steel flange is forged and machined in Ohio from US melted bar. Its cost records show material 40 dollars, labor and overhead 35 dollars, and an imported coating 10 dollars on an 85 dollar part cost, so domestic content is 75 of 85, about 88 percent. The percent and the calculation basis go on the form. The buyer then compares the number with the threshold in its contract.

#### Common mistakes

**Body:** Common problems are suppliers declaring origin without checking sub-tier sources, mixing up country of origin for customs with domestic content for procurement, and not updating the declaration after a change of mill or casting source. Ask for sub-tier declarations on critical parts and keep them with the supplier record.

**Cta:** If your ERP vendor and item records can carry origin and declaration expiry dates, a simple report can flag parts without a current declaration. We can help design that.

**Faq:**

#### Is this form the same as a certificate of origin?

**Answer:** No. A certificate of origin supports customs or trade agreement claims. This is a supplier declaration of manufacturing location and domestic content for procurement purposes.

#### Does it need to be notarized?

**Answer:** Not unless your customer or contract requires an affidavit. Many buyers accept a signed declaration, but check your flow-down clauses.

#### Can one declaration cover many parts?

**Answer:** Yes, list each part number in the table. Keep the date and revision so you know which parts and which period the declaration covers.

#### How do I calculate domestic content?

**Answer:** Use the method required by your contract. A common approach is the cost of domestic components divided by the cost of all components, but definitions of cost and included items differ.

## Search terms

country of origin supplier declaration template, domestic content affidavit template, supplier origin certification form, buy american supplier certificate, made in usa supplier affidavit, country of origin statement for parts

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