普惠制原产地证样本

单证

1. Goods consigned from (Exporter's business name, Reference No. address, country)

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 number

6. Marks 7. Number and kind of packages; description of 8. Origin 9. Gross and goods criterion weight numbers (see Notes or other of overleaf) quantity packages

10. Number and date of invoices

单证

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

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 and stamp of certifying authority -------------------------------------------------------------------------------------------------------Place and date, signature and stamp of authorized signatory --------------------------------------------------------------------------------

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