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{"sheet":"Pro-forma","index":0,"n_rows":36,"n_cols":12,"rows_kept":36,"cut":false,"hidden":false,"merged":[[0,9,0,10],[0,0,1,2],[31,0,31,5],[5,0,5,2],[5,4,5,5],[11,4,11,5],[1,4,3,5],[10,0,10,2],[11,0,11,2],[32,0,32,5],[35,0,35,11],[6,7,6,11],[10,7,10,11],[9,7,9,11],[7,7,7,11],[7,4,7,5],[9,4,9,5],[10,4,10,5],[11,7,11,11],[6,4,6,5],[29,6,29,11],[6,0,6,2],[7,0,7,2],[9,0,9,2]]}
["Pro-Forma Invoice",null,null,null,"Invoice Date:",null,null,null,null,"AWB/Tracking:"]
[]
[]
[]
[]
["Shipper :",null,null,null,"Consignee :",null,null,"Note:"]
[null,null,null,null,"EIN# 33-0463207",null,null,"Complete shaded areas of the Pro-Forma Invoice."]
[null,null,null,null,"AOA Laboratory",null,null,"Email invoice to international.shipments@aoalab.com "]
[null,null,null,null,"A Division of Ormco Corporation"]
[null,null,null,null,"13931 Spring Street"]
[null,null,null,null,"Sturtevant WI  53177   USA",null,null,"Place 1 copy in box and 1 copy on the outside of the box."]
[null,null,null,null,"Phone : 262-321-3617"]
[]
["Merchandise Description","HTS #","Quantity Shipped","Unit of Measure","Country of Origin","Unit Cost","Value in US Dollars","FDA Registration No.","FDA Product Code","Device Listing No.","510(k)","Notes"]
["Dental Impression","8480.60.0090",null,"Each",null,8.5,{"$f":"C15*F15","v":0},"N/A","N/A","N/A","N/A"," "]
["Bite Registration","9602.00.4000",null,"Each",null,2,0,"N/A","N/A","N/A","N/A"," "]
["Dental Model","6809.90.0000",null,"Each",null,8,0,"N/A","N/A","N/A","N/A"]
["3D Resin Dental Model","3926.90.9995",null,"Each",null,8,0,"N/A","N/A","N/A","N/A"]
["Aligners","9021.10.0090",null,"Each",null,377,0,2184045,"NXC","E384896","K040874"]
["Clear Guide","9021.10.0090",null,"Each",null,627,0,2184045,"NXC","D146390","K093821"]
["Positioners/ Splints","9021.10.0090",null,"Each",null,101,0,2184045,"KMY","E202265","Exempt"]
["Sleep Apnea/Snore","9021.10.0090",null,"Each",null,221,0,2184045,"LRK","D074794","K070327"]
["Herbst/MARA","9021.10.0090",null,"Each",null,225,0,2184045,"EJF","E345545","Exempt"]
["Functional Appliance","9021.10.0090",null,"Each",null,103,0,2184045,"DYJ","E251802","Exempt"]
["Retainer","9021.10.0090",null,"Each",null,103,0,2184045,"DYJ","E251802","Exempt"]
["Fixed Metals/DJ","9021.10.0090",null,"Each",null,103,0,2184045,"DYJ","E251802","Exempt"]
[]
[]
[null,null,null,null," ","Total",{"$f":"SUM(G15:G26)","v":0}]
[null,null,null,null," ",null,"***Values are for Customs purposes only***"]
[]
["All \"Quantity Shipped\" fields must have a numeric value. Use \"0\" if item is not included in shipment."]
["All items in shipment MUST be listed on this Pro-forma Invoice. Use blank lines if needed."]
[]
[]
["“These items are controlled by the U.S. Government and authorized for export only to the country of ultimate destination for use by the ultimate consignee or end-user(s) herein identified. They may not be resold, transferred, or otherwise disposed of, to any other country or to any person other than the authorized ultimate consignee or end-user(s), either in their original form or after being incorporated into other items, without first obtaining approval from the U.S. Government or as otherwise authorized by U.S. law and regulations.\""]