| | | Образец бланка сертификата
|
1. Goods consigned from
(exporter's business name,
address, country)
| Reference No
GENERALIZED SYSTEM OF
preFERENCES
|
2. Goods consigned to
(consignee's name,
address, country)
| CERTIFICATE OF ORIGIN
(Combined declaration and
certificate)
FORM A
Issued in ___________________
(country)
See notes overleaf
|
3. Means of transport and
routs (as far as known)
| 4. For official use
|
5. Item
number
| 6. Marks
and
numbers
of
packages
| 7. Number
and kind
of
packages;
description
of goods
ОБРАЗЕЦ
| 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.
___________________________
Place and date, signature
and stamp of certifying
authority
| 12. Declaration by the exporter
The undersigned hereby
declares that the above
details and statements are
correct; that all the goods
were
produced in _______________
(country)
and that they comply with
the origin requirements
specified for those goods
in the generalized system
of preferences for goods
exported to
___________________________
(importing country)
___________________________
Place and date, signature
of authorized signatory
|