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SAMPLE CERTIFICATE OF ORIGIN

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..... e 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 in the Asia-Pacific Trade Agreement for goods exported to .................................... (Importing Country) ................................................................ Place and date, signature of authorized Signatory 12. Certificate 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 Certifying Authority Notes for completing Certificate of Origin I. General Conditions: To qualify for preference .....

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..... rs of Packages Type the marks and numbers of the packages covered by the Certificate. This information should be identical to the marks and numbers on the packages. Box 7 Number and Kind of Packages; Description of Goods Type clearly the description of the products exported. This should be identical to the description of the products contained in the invoice. An accurate description will help the Customs Authority of the country of destination to clear the products quickly. Box 8 Origin Criterion Preference products must be wholly produced or obtained in the exporting Participating State in accordance with Rule 3 of the Asia-Pacific Trade Agreement Rules of Origin, or where not wholly produced or obtained in the exporting Participati .....

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..... rer. Type the name of the producing country and the importing country and the place and date when the declaration is made. This box must be signed by the Company's authorized signatory. Box 12 Certification The certifying authority will certify in this Box. OLD Form Annexure-I Form Domestic Procurement Certificate Certificate for removal of goods under bond This is to certify that - (1) Mr./M/s ----------------(Name and address) is/are a bona fide unit in the special economic zone holding Letter of Permission No.------valid upto ----- (2) That he/they has executed a bond No-------date ------for Rs. --------with the Assistant Commissioner or Deputy Commissioner of Customs of the special economic zone and as such may be permit .....

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