Page 1 of
Certificate No：
6.Item number
| 7.Marks and numbers on packages
| 8.Number and kind of packages； Description of goods
| 9. HS Code （6-digit）
| 10. Origin Criterion
| 11. Gross weight， quantity （quantity unit） or other measures （litres， m3，etc）
| 12. Number， date of
invoice and
invoiced value
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13. Declaration by the exporter
The undersigned hereby declares that the above
details and statements are correct， that all the goods were produced in
……………………………………………
（country）
and that they comply with the origin requirements
specified for these goods under the Duty-Free Treatment exported to China.
………………………………………………
Place and date， signature of authority signatory
| 14.Certification
It is hereby certified， on the
basis of control carried out，
that the declaration by the exporter is correct.
…………………………
Place and date， signature and stamp of issuing authority
| 15. Customs verification
This is to certify that the goods declared for exportation correspond to what is stated under this certificate
…………………………
Place， date， signature and stamp of exporting customs authority.
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Page 2 of
Overleaf Instruction
Certificate No.： Serial number of Certificate of Origin assigned by the issuing body.
Box 1： State the full legal name， address （including country） of the exporter and the exporter should be in the beneficiary country.
