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1、ORIGINAL1 .Goods consianed from (Exoorters business name. address, country)Reference No.GENERALIZED SYSTEM OF PREFERENCESCERTIFICATE OF ORIGIN (Combined declaration and certificate)FORM A|ssued jn THE PEOPLES REPUBLIC OF CHINA(country)See Notes overleaf2.Goods consianed to (Consianees name, address.
2、country)3. Means of transport and route (as far as known)4 For official use.5. Item num ber6 Marks and.7.Number and kind of packages; description of8.0riain criterion (see Notes overleaf)9.Gross weiahtor other quantity10.Number and date of invoicesnumbers of packagesaoods11. CertificationIt is hereb
3、y certified, on the basis of control carried out12. Declarationby the exporterdares that the above details andThe undersigned hereby dethat the declaration by the exporters correct.statements are correct, that all the qoods wereCHINA produced in(country) and that they comply with the origin requirements specified for those goods in the Generalized System of Preferences for goods exported toPlace and date, signature and stamp of certifying authority Place and date, signature and stamp of authorized signatory