1、1、Goods con sig ned Refere nee No.See Notes overleaf(country)fromGENERALIZED SYSTEN OF(Exporter sPREFERENCES CERTIFICATE OF ORIGINBus in ess(Combined declaration and certificate)n ame,FORM Aaddress, counIssued inP. R. CHINAtry)2、Goods,4、For official use con sig nedto(Co n signee sName,address, count

2、ry)3、Mea ns oftran sport and route (as far asknown)6、Marks7、Numberand8 Origin9、Gross10、Numbe5、Itemandkindcriteri onweight orand date ofnu mbernuof packages;(see Notesotherinv oicesmberofdescripti on overleaf)qua n tity)packages of goods11、Certificati onIt is hereby certified, on the basis of con tro

3、l carried out, that the declarati onby the exporter is correct.Place and date, sig nature and stamp of certify ing authorized12、Declaration by the exporterThe un dersig ned hereby declares that the above details and statare correct; that all the goods were produced inCHINA and thatcomply(cowith the

4、origin requirements specified for those goods in the GenerSystem of Prefere n ces for goods exported tomport ing countryPlace and date, sig n ature of authorized sig n atory證號(hào):1、發(fā)貨地方出口商名址國(guó)別2、收貨地點(diǎn)收貨人名址國(guó)別3、運(yùn)輸工具、路線盡量詳細(xì)普惠制原產(chǎn)地證書(shū)格式A中華人民共和國(guó)簽發(fā)見(jiàn)反面?zhèn)渥?、不填號(hào) 碼11、簽證茲證明：經(jīng)檢驗(yàn)出口商申報(bào)內(nèi)容無(wú)誤。受權(quán)簽字人簽名簽名日期、地點(diǎn)5、項(xiàng)6、標(biāo)志、號(hào) 7、件數(shù)、貨8產(chǎn)地成份9、毛重、數(shù)10、發(fā)票號(hào)碼、比例量日期12、J商