原产地证明书样本

2.Goods consignedto:Consignee sname,address,countryOfficial use

4.Means oftransport androute:item number:

6.Marks andnumber ofPackages:

7.Numberand kindof packages/descriptionof goods:

8.Origincriterionsee notesoverleaf

9.Gross

（2）如果符合第四条规定的原产地标准，则在第8栏中填写字母“C”在字母“C”的后面填上在出口成员国原产成份的累计总和，以占出口货物的成本加运费、保险费价格（CIF价格）的百分比表示，（如“C60%）;

（3）如果符合原产地规则第十条规定的特殊比例标准，则第8栏中填写字母“D”；第9栏毛重或者其他数量注明货物毛重或者其他数量（如件数、公斤）第10栏发票编号及日期注明发票编号及日期随附发票上的日期不应当迟于原产地证书格式正式启用的日期第11栏出口人声明“出口人”是指发货人，该发货人可以是贸易商也可以是创造商声明中应当注明原产国、进口国、地址和日期且该栏目应当由公司授权人员签名第12栏证明本栏目由签证机构签章确认weight or other quantity:

10.Number and date ofinvoices:

11.Declaration by the exporter:The undersignedhereby declaresthat theabove detailsandstatements arecorrect:that allthe goodswere producedinCountryandthat theycomply with the originrequirementsspecified forthese goodsin theAsia-Pacific TradeAgreementfor goodsexported to■Importing CountryPlace and date,signature ofauthorizedSignatory

12.CertificateIt ishereby certifiedon thebasis ofcontrol carriedout,that thedeclaration by the exporteris correct.Placeanddate,signature andStamp ofCertifyingAuthorityNotes forcompleting Certificateof Origin

1.General Conditions:To qualifyfor preference,products must:a fallwithin adescription ofproducts eligibleforpreference in the listof concessionsof anAsia-Pacific TradeAgreementcountry of destination;b complywith Asia-Pacific TradeAgreement rulesoforigin.Each articlein aconsignment mustqualify separatelyinits ownright;andc complywiththeconsignment conditionsspecifiedby theAsia-Pacific TradeAgreement rulesof origin.In general,products must be consigneddirectly within the meaningof Rule5hereof fromthe countryof exportationto the country ofdestination.to bemade inthe boxesBoxlGoods Consigned fromType the name,addreand countryof the exporter.The namemust be the same as theexporterdescribed inthe invoice.Box2GoodsConsignedtoType thename,addreand countryof theimporter.The namemust bethesameastheimporter describedin theinvoice.For thirdparty trade,the words“To Ordermaybetyped.Box3For OfficialUseReserved foruse bycertifying authority.Box4Means ofTransport andRouteState indetail themeans oftransport androute fortheproducts exported.If theL/C termsetc.do notrequire suchdetails,type“By Air”or“By Sea”.If theproducts aretransportedthrough athird countrythis canbe indicatedasfollows:By Air”“Laos toIndia viaBangkokvBox5Tariff ItemNumberType the4-digit HSheading of the individualitems.Box6Marks andNumbers ofPackagesType themarks andnumbers of the packagescovered by theCertificate.This informationshould be identical to the marksandnumbers onthe packages.Box7Number andKind ofPackages;Description ofGoodsType clearlythe description of theproducts exported.This should beidenticalto thedescriptionof the productscontainedintheinvoice.An accuratedescription willhelpthe CustomsAuthority of thecountryofdestinationto cleartheproducts quickly.Box80rigin CriterionPreferenceproducts mustbe wholly produced or obtainedin theexporting ParticipatingState inaccordance withRule2of theAsia-Pacific TradeAgreement Rulesof Origin,or wherenot wholly produced or obtainedintheexporting ParticipatingStatemustbeeligible underRule3or Rule

4.a Productswhollyproducedorobtained:enter theletterA in Box

8.b Productsnotwhollyproducedorobtained:the entryin Box8shouldbe as follows:letter Bin Box8,for productswhich meetthe origincriteria according to Rule

3.Entry ofletter Bwould befollowedbythesum of the value of materials,parts orproduceoriginating fromnon-Participating States,or undeterminedoriginused,expressed asa percentageofthevalueoftheproducts;example B50per cent;letter CinBox8for productswhich meetthe origincriteriaaccording toRule

4.Entry ofletter Cwouldbe followedbythesum ofthe aggregatecontentoriginating inthe territoryoftheexportingParticipating Stateexpressed asa percentageof thevalueoftheexported product;example C60percent;letter DinBox8for productswhich meetthe specialorigincriteriaaccordingtoRule

10.Box9GroWeight orOther QuantityTypethe groweightorotherquantity suchas pieces,kgof theproducts coveredbythe Certificate.Box10Number andDate ofInvoicesState numberanddate oftheinvoice inquestion.The dateoftheinvoice attachedtotheApplication shouldnotbe laterthan thedateofapproval ontheCertificate.Box11Declaration bythe ExporterTheterm“Exporter“refers tothe shipperwho caneitherbeatrader ora manufacturer.Typethename oftheproducing countryand theimporting countryand theplace anddatewhen thedeclaration ismade.This boxmustbesigned bytheCompanys authorizedsignatory.Box12CertificationThe certifyingauthority willcertify inthis Box.原产地证书样本亚太贸易协定（中文文本仅供参考）（申报和证书合一）

1.货物运自（出口人名称、地址、国家）编号（国家）

2.货物运至（收货人名称、地址、国家）

3.官方使用

4.运输工具及路线

5.税则号列

6.包装啧头及编号

7.包装件数及种类；货物名称

8.原产地标准（见背页说明）

9.毛重或者其他数量

10.发票编号及日期

11.出口人声明下列签字人证明上述资料及申明正确无讹，所有货物产（国家）且符合亚太贸易协定原产地规则的相关规定，该货物出口至（进口国）申报地点、日期及授权签字人的签字

12.证明根据所实施的监管，兹证明上述出口商的申报正确地点和日期，签字和签证机构印章背页填制说明

一、总原则享受关税减让优惠的货物必须符合以下条件

1.属于《亚太贸易协定》进口成员国关税减让优惠产品清单的范围

2.符合《亚太贸易协定》原产地规则同批货物中的每项商品均要符合该规则

3.符合《亚太贸易协定》原产地规则中的直接运输条款规定普通情况下，货物必须按照第五条的规定从出口国直接运输到进口国

二、表格各栏应填写的内容第1栏货物出口人注明出口人的全称、地址和国家须与发票上的出口人名称一致第2栏货物收货人注明收货人的全称、地址和国家该收货人名称必须与发票上的进口商名称一致如果属于第三方贸易，应该注明“凭背书”字样第3栏官方使用由签发证书机构填写第4栏运输工具和路线详细注明出口货物的运输工具和路线如果信用证等单证未详细列明时，应注明“空运”或者“海运”字样；如果货物运输途中经过第三国时，应当按照下列方式注明例如“空运”“从老挝至印度途经曼谷”第5栏税则号列注明各项商品的4位HS编码第6栏包装唆头及编号注明包装上的陵头及编号应当与货物包装上的陵头及编号相一致第7栏包装件数及种类；货物名称注明出口货物名称应当与发票上的名称相符准确的货物名称有助于进口国海关快速清关第8栏原产地标准享受关税减让优惠的货物必须符合《亚太贸易协定》原产地规则第二条规定，是在出口成员国彻底获得或者生产的；或者在出口成员国非彻底获得或者生产的符合原产地规则第三条、第四条规定的

1.彻底获得或者生产的在第8栏中填写字母“A”

2.非彻底获得或者生产的在第8栏中应当按照下列方式填写

（1）如果符合第三条规定的原产地标准，则在第8栏中填写字母“B”在字母的后面填上使用非成员国原产或者不明原产地的材料、零件或者产物的总价值，以在船上交货价格（FOB价格）中所占的百分比表示，（如“B”50%）;。