中国—智利自由贸易区原产地证书样本及其填制说明.doc

中国—智利自由贸易区原产地证书样本及其填制说明 Certificate of Origin ORIGINAL 1.Exporter’s name, address, country: Certificate No.: CERTIFICATE OF ORIGIN Form F for China-Chile FTA Issued in ____________ (see Instruction overleaf) 2. Producer’s name and address, if known: 3.Consignee’s name, address, country: 4.Means of transport and route (as far as known) Departure Date Vessel /Flight/Train/Vehicle No. Port of loading Port of discharge 5. For Official Use Only Preferential Tariff Treatment Given Under _______ Preferential Treatment Not Given (Please state reasons) …...………………………………………… Signature of Authorized Signatory of the Importing Country 6. Remarks 7.Item number (Max 20) 8. Marks and numbers on packages 9. Number and kind of packages; description of goods 10. HS code (Six digit code) 11. Origin criterion 12. Gross weight, quantity (Quantity Unit) or other measures (liters,m3,etc) 13. Number, date of invoice and invoiced value 14．Declaration by the exporter The undersigned hereby declares that the above details and statement are correct, that all the goods were produced in （Country） and that they comply with the origin requirements specified in the FTA for the goods exported to （Importing country） Place and date, signature of authorized signatory 15．Certification It is hereby certified, on the basis of control carried out, that the declaration of the exporter is correct. Place and date*, signature and stamp of certifying authority Certifying authority Tel: Fax: Address: Overleaf Instruction Box 1: State the full legal name, address (including country) of the exporter. Box 2: State the full legal name, address (including country) of the producer. If more than one producer’s good is included in the certificate, list the additional producers, including name,