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1. Goods consigned from (Exporter's business name, address, country) |
Reference No. |
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GENERALIZED SYSTEM OF PREFERENCES
CERTIFICATE OF ORIGIN
(Combined declaration and certificate) |
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2. Goods consigned to (Consignee's name, address, country) |
FORM A |
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Issued in |
THE PEOPLE'S REPUBLIC OF CHINA |
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(country) |
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See Notes overleaf |
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3 Means of transport and route (as far as known) |
4. For official use |
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5. Item num-
ber |
6. Marks and
numbers of
packages |
7. Number and kind of packages; description of goods |
8. Origin
criterion
(see Notes
overleaf) |
9. Gross
weight
or other
quantity |
10. Number
and date of
invoices |
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11. Certification
It is hereby certified, on the basis of control carried out, that the declaration by the exporter is correct. |
12. Declaration by the exporter
The undersigned hereby declares that the above details and statements are correct, that all the goods were |
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produced in |
CHINA |
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(country) |
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and that they comply with the origin requirements specified for those goods in the Generalized System of Preferences for goods exported to |
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Place and date, signature and stamp of certifying authority |
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Place and date, signature and stamp of authorized signatory |
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