3. Форма сертификата о происхождении товара на английском языке

3. Форма сертификата о происхождении товара

на английском языке

1. Consignor/exporter (name and address)					4. N ______
					CERTIFICATE OF ORIGIN
2. Consignee/importer (name and address)					Issued in	________________________ (country)
					For submission to		__________________ (country)
3. Means of transport and route (as far as known)					5. For official use

6. N	7. Number and kind of packages		8. Description of goods			9. Quantity of goods

10. Certification					11. Declaration by the applicant
It is hereby certified, on the basis of control carried out, that the declaration by the applicant is correct					The undersigned hereby declares that the above details are correct, that all goods are originating in ____________________________________ (country)
					and comply with the origin requirements specified for those goods

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Signature		Date		Stamp	Signature	Date		Stamp