Annex 3-A CERTIFICATE OF ORIGIN (SAMPLE ONLY- ORIGINALS TO BE SUPPLIED BY AUTHORISED BODIES) 1. Exporter’s name, address and country: Certificate No.: CERTIFICATE OF ORIGIN Form for China-Australia Free Trade Agreement 2. Producer’s name and address (if known): Issued in: 3. Importer’s name, address and country (if known): For official use only: 4. Means of transport and route (if known) 5. Remarks: Departure date: Vessel/Flight/Train/Vehicle No.: Port of loading: Port of discharge: 6. Item 7. Marks and 8. Number and kind of 9. HS code 10. Origin 11.Gross or net 12. Invoice numbers on packages; description of criterion weight or other number and number (6-digit code) packages goods quantity (e.g. date (max. (optional) Quantity Unit, 20) litres, m3.) 13. Declaration by the exporter or producer 14. Certification The undersigned hereby declares that the On the basis of the control carried out, it is hereby certified information is correct and that the goods exported to that the information herein is correct and that the described goods comply with the origin requirements of the ___________________________________ Free Trade Agreement. (Importing Party) comply with the origin requirements specified in the China-Australia Free Trade Agreement. date, and signature and stamp of the Authorised Body Tel: Fax: Address: Place, date and signature of authorised person
Annex 3-A CERTIFICATE OF ORIGIN (SAMPLE ONLY- ORIGINALS TO BE SUPPLIED BY AUTHORISED BODIES) 1. Exporter’s name, address and country: Certificate No.: CERTIFICATE OF ORIGIN Form for China-Australia Free Trade Agreement Issued in: 2. Producer’s name and address (if known): 3. Importer’s name, address and country (if known): For official use only: 4. Means of transport and route (if known) Departure date: Vessel/Flight/Train/Vehicle No.: Port of loading: Port of discharge: 5. Remarks: 6. Item number (max. 20) 7. Marks and numbers on packages (optional) 8. Number and kind of packages; description of goods 9. HS code (6-digit code) 10. Origin criterion 11.Gross or net weight or other quantity (e.g. Quantity Unit, litres, m3.) 12. Invoice number and date 13. Declaration by the exporter or producer The undersigned hereby declares that the information is correct and that the goods exported to ___________________________________ (Importing Party) comply with the origin requirements specified in the China-Australia Free Trade Agreement. Place, date and signature of authorised person 14. Certification On the basis of the control carried out, it is hereby certified that the information herein is correct and that the described goods comply with the origin requirements of the Free Trade Agreement. date, and signature and stamp of the Authorised Body Tel: Fax: Address:
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