办理商检局普惠制原产地证书（FORM A）空白表格

2.Goods consignee   to (Cousignee's   name, address,country) 客户名称/公司地址

3.Means of   transport and route(as far as known) 运输方式出货日期

4.For official   use

1．FROM (起运港)TO   (目的地)BY(海运/空运)   ON/AFTER (出货日期)

2．FROM (起运港)TO   (中转港)BY(TRUCK) ON/AFTER (出货日期) THEN   TRANSHIPPED TO(目的地) BY(海运/空运)

5.Item

num

ber

6.Mrks and num ber of

packages

7.Number and kind   of packages;description of goods  

品名和箱数     

8.Origin  criterion

(seeNotes

overleaf)

产品编号 

9.Gross

weight

or other

quantity

个数

10.Number

and date of

invoices

    唛头   

发票号和日期

“P”

含有进口成分为W+百分比

到RUSSIA,乌克兰的含有进口成分的打Y+百分比

11.Certification

   It is hereby   certified,on the basis of control carried out,       

   the   dsclaration by the exporter is correct.

商检局盖印

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 Place and date. signature and stamp of   certifying authority     

12.Declaration    by  the  exporter

he   undersigned hereby declares that the above detail and

statements   are correct that the goods were produce in

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  and that they   comply with the original requirements sp ecified

  for those goods   in the Generaliderl System of Preferences for

  goods exp   orted to        我司盖印

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             (import    country )

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    Place and date,signature of authorized signatory