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Domestic Origin Supplier Affidavit Template

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.

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Domestic Origin Supplier Affidavit Template

Supplier Declaration of Country of Origin and Domestic Content

Buyer: Lone Star Precision Machining LLC Supplier: Midwest Forge and Casting Co. Address: 88 Foundry Road, Dayton, OH 45402, USA Reference: PO-77412

Parts covered

Part numberDescriptionCountry of final manufactureRaw material originDomestic content %
FRG-2201-BForged steel flange, 4140 alloyUnited StatesUnited States78

Basis of calculation

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

Statement

The undersigned declares on behalf of Midwest Forge and Casting Co. 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 Lone Star Precision Machining LLC in writing if the origin or domestic content of the listed parts changes.

Signature

Name and title: Chris Meyer, VP Operations Date: 2026-10-20

Authorized supplier representative / Date
Buyer receiving inspector / Date

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.

Track supplier declarations in your ERP

Optional: discuss a vendor declaration expiry report for your ERP.

Optional. The tool and every export work without this. No spam.

How to use the template

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.

  • 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

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

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

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.

Frequently Asked Questions

Is this form the same as a certificate of origin?

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?

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?

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?

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.

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.