原产地证书 英文版 English.docVIP

Original (Duplicate/Triplicate) Reference No. 1. Products consigned from (Exporters business name, ASEAN-CHINA FREE TRADE AREA address, country) PREFERENTIAL TARIFF CERTIFICATE OF ORIGIN (Combined Declaration and Certificate) ? 2. Products consigned to (Consignees name, address, FORM E country) Issued in ______________ (Country) See Overleaf Notes 3. Means of transport and route (as far as known) 4. For Official Use ? ? ? Departure date Preferential Treatment Given Vessels name/Aircraft etc. Preferential Treatment Not Given (Please state reason/s) ? ? ? ? ? ? Port of Discharge ? ? ? .................................................................................. Signature of Authorised Signatory of the Importing Party ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 5. Item 6. Marks and 7. Number and type of 8. Origin criteria 9. Gross 10. Number and number numbers on packages, description of (see Overleaf weight or date of packages products (including quantity Notes) other quantity invoices where appropriate and HS and value number of the importing (FOB) Party) ? ? ? ? ? ? ? ? ? ? ? ? ? ? 11. Declaration by the exporter 12. Certification The undersigned hereby declares that the above It is hereby certified, on the basis of control details and statement are correct; that all the products carried out,