СОГЛАШЕНИЕ стран СНГ от 12.04.96 (ред. от 07.10.2002) "О ПРАВИЛАХ ОПРЕДЕЛЕНИЯ ПРОИСХОЖДЕНИЯ ТОВАРОВ РАЗВИВАЮЩИХСЯ СТРАН ПРИ ПРЕДОСТАВЛЕНИИ ТАРИФНЫХ ПРЕФЕРЕНЦИЙ В РАМКАХ ОБЩЕЙ СИСТЕМЫ ПРЕФЕРЕНЦИЙ"
Графа 12
В верхней строке указывается наименование страны происхождения товара.
В средней строке указывается наименование страны назначения товара.
В нижней строке указывается место и дата заполнения сертификата. Сведения, приведенные в сертификате, подписываются в данной графе уполномоченным лицом экспортера (поставщика), указанного в графе 1. Наличие печати экспортера (поставщика) в графе допускается, но не является обязательным требованием.
| 1. Goods consigned from (exporter's business name, address, country) | | Reference N | |
| | GENERALIZED SYSTEM OF preFERENCES | |
| | | |
| | CERTIFICATE OF ORIGIN | |
| | | |
| 2. Goods consigned to (consignee's name, address, country) | | (Combined declaration and certificate) | |
| | | |
| | FORM A | |
| | | |
| | Issued in | |
| | | (country) | |
| | | |
| | See notes overleaf | |
| 3. Means of transport and route (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 | 8. Origin criterion (see notes overleaf) | 9. Gross weight or other guantity | 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 | | | |
| | | | | | | | (county) | |
| | | | | | | and that they comply with the origin reguirements specified for those goods in the generalized system of preferences for goods exported to | |
| | | | | | | | | | |
| | | | | | | (importing country) | |
| | | | | | | | | | |
| | Place and date, signature and stamp of certifying authority | | | Place and date, signature of authorized signatory | |