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海关总署公告2006年第55号--关于《中华人民共和国与智利共和国政府自由贸易协定》中智自贸协定原产地规则及相关程序


  附表2
  原产地证书格式
  ORIGINAL
┌────────────────┬────────────────────────────┐
│1.Exporter’s name, address,  │Certificate No.:                    │
│ country:           │                            │
│                │CERTIFICATE OF ORIGIN                  │
├────────────────┤                            │
│2. Producer’s name and addr  │Form F for China-Chile                 │
│ess,              │ FTA                          │
│ if known:           │                            │
├────────────────┤Issued in ____________                 │
│3.Consignee’s name, address  │(see Instruction                    │
│, country:           │ overleaf)                       │
├────────────────┼────────────────────────────┤
│4.Means of transport and    │5. For Official Use Only                │
│route              │         Preferential             │
│ (as far as known)       │ Tariff Treatment Given Under _______         │
│                │                            │
│  Departure Date        │                            │
│                │ Preferential Treatment Not Given (Please state    │
│ Vessel            │reasons)                        │
│ /Flight/Train/Vehicle No.   │…...…………………………………………          │
│                │Signature of Authorized                 │
│ Port of loading        │ Signatory of the Importing Country          │
│                │                            │
│Port of discharge        ├────────────────────────────┤
│                │6. Remarks                       │
│                │                            │
├───┬────┼───────┼───────────┬────┬─────┬─────┤
│7.It │8. Mar │9. Number and │10. HS code      │11. Orig│12. Gross │13. Number│
│em  │ks and │kind of packag│(Six digit code)   │in crite│weight, qu│, date of │
│number│numbers │es;      │           │rion  │antity  │invoice  │
│(Max │on   │ description │           │    │(Quantity │and    │
│ 20) │packages│of goods   │           │    │Unit) or │invoiced │
│   │    │       │           │    │other mea │value   │
│   │    │       │           │    │sures (lit│     │
│   │    │       │           │    │ers,m3,etc│     │
│   │    │       │           │    │)     │     │
├───┴────┴───────┴─────┬─────┴────┴─────┴─────┤
│14.Declaration by the exporter       │15.Certification              │
│The undersigned hereby declares       │It is hereby                │
│ that the above details and statement a  │ certified, on the basis of control carri │
│re correct, that all the goods were     │ed out, that the declaration of the     │
│ produced in                │ exporter is correct.           │
│                      │                      │
│                      │                      │
│   (Country)              │                      │
│and that they comply with the        │                      │
│ origin requirements specified in the F  │Place and date*, signature and stamp of ce │
│TA for the goods exported to        │rtifying authority             │
│                      │                      │
│                      │                      │
│                      │Certifying authority            │
│     (Importing country)       │Tel:                    │
│                      │ Fax:                   │
│                      │Address:                  │
│Place and date, signature of        │                      │
│ authorized signatory           │                      │
└──────────────────────┴──────────────────────┘


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