1. Goods consigned from (Exporter's business name, address, country) | Reference No. |
|
| GENERALIZED SYSTEM OF PREFERENCES CERTIFICATE OF ORIGIN (Combined declaration and certificate) |
2. Goods consigned to (Consignee's name, address, country) | FORM A |
| Issued in | THE PEOPLE'S REPUBLIC OF CHINA |
|
| (country) |
|
See Notes overleaf |
3 Means of transport and route (as far as known) | 4. For official use |
|
|
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 |
|
|
|
|
|
|
|
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 |
produced in | CHINA |
|
| (country) |
and that they comply with the origin requirements specified for those goods in the Generalized System of Preferences for goods exported to |
|
|
|
|
|
|
---------------------------------------------------------------------------------------------------------- Place and date, signature and stamp of certifying authority | ---------------------------------------------------------------------------------------------------------- Place and date, signature and stamp of authorized signatory |
