SAMPLE CERTIFICATE OF ORIGIN

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....iff item number: 6.Marks and number of Packages: 7. Number and kind of packages/description of goods: 8. Origin criterion (see notes overleaf) 9. Gross weight or other quantity: 10. Number and date of invoices:  11. Declaration by the exporter : The undersigned hereby declares that the above 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, si....

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....n detail the means of transport and route for the products exported. If the L/C terms etc. do not require such details, type By Air or By Sea. If the products are transported through a third country this can be indicated as follows: e.g. °By Air" °Laos to India via Bangkok" Box 5 Tariff Item Number Type the ^1[6-digit HS heading] of the individual items.  Box 6 Marks and Numbers 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....

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....in Box 8 for products which meet the origin criteria according to sub-rule (b) of rule 4. Entry of letter "E" would be followed by the criteria of the rules of origin (example "E" CTH).] Box 9 Gross Weight or Other Quantity Type the gross weight or other quantity (such as pieces, kg) of the products covered by the Certificate.   Box 10 Number and Date of Invoices State number and date of the invoice in question. The date of the invoice attached to the Application should not be later than the date of approval on the Certificate. Box 11 Declaration by the Exporter The term "Exporter" refers to the shipper who can either be a trader or a manufacturer. Type the name of the producing country and the importing country ....