| 发货人（卖方）的名称与详细地址 | Reference No.添加号码 GENERALIZED SYSTEM OF PREFERENCES CERTIFICATE OF ORIGIN (Combined declaration and certificate) FORM A Issued in THE PEOPLE’S REPUBLIC OF CHINA
Country) See Notes Overleaf | ||||
| 2.Goods consigned to (Consignee’s name, address, country) 国外收货人（买方、报关人）的名称与详细地址 | |||||
| 3.Means of transport and route(as far as know) 运输方式与线路 BY SEA FROM SHANGHAI,CHINA TO KOBE, JAPAN | 4.For official use | ||||
| 5.Item Num- Ber 1 | 6.Marks and numbers of packages 与、提单保持一致 | 7.Number and kind of packages; description of goods 包装方式与外包装件数 具体的商品名称 SAY: TOTAL FORTY CTNS ONLY. ********** | 8.Origin criterion (see Notes overleaf) CHINA | 9.Gross weight or other quantity 10,000 KGS | 10.Number and date of invoices 出口号码与日期 |
| 11.Certification It is hereby certified, on the basis of control carried out, that the declaration by the exported is corrected. 出证机构签字、盖章（日期等同于或晚于日期，但不迟于提单日期） -------------------------------------------------------------------- Place and date, signature and stamp of certifying authority | 12.Declaration by the exporter The undersigned hereby declares that the above details and statements are correct; that all the goods were produced in CHINA -------------------------------------------------------------- (country) And that they comply with the origin requirements specified for those goods in the Generalized System of Preferences for goods exported to JAPAN -------------------------------------------------------------- (importing country) 出口公司签字、盖章(日期不迟于提单日期) -------------------------------------------------------------- Place and date, signature of authorized signatory | ||||
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