ФОРМА СЕРТИФИКАТА О ПРОИСХОЖДЕНИИ ТОВАРА ФОРМЫ EAV

1. Exporter (business name, address and country)					4. No. ____
					EAEU-VN FTA Certificate of Origin Form EAV
2. Importer/Consignee (business name, address and country)					Issued in
					__________________________________ (country)
					For submission to
					__________________________________ (country)
3. Means of transport and route (as far as known)					5. For official use

6. Items No.	7. Number and kind of packages		8. Description of goods		9. Origin criterion		10. Quantity of goods		11. Number and date of invoice



12. Certification It is hereby certified, on the basis of control carried out, that the declaration by the applicant is correct					13. Declaration by the applicant The undersigned hereby declares that the above details are correct: that all goods were produced in
					________________________________ (country)
					and that they comply with the rules of origin as provided in Chapter 4 (Rules of Origin) of the EAEU-VN FTA

Place	Date	Signature		Stamp	Place	Date		Signature		Stamp