10国商3班 业务五部 Form A

Certificate of Origin 1. Exporter’s name, address, country: NAN DAO ZHU CANE FURNITURE CO,LTD　 237 KEHUA STREET TIANHE DISTRICT GUANGZHOU Tel:020-87605432 Fax:8620-55564738 Certificate No.: CERTIFICATE OF ORIGIN Form F for China-Chile FTA Issued in CHINA 2. Producer’s name and address, if known: 佛山市南海区裕达家具有限公司 中国广东省佛山市南海区大冲工业区 3. Consignee’s name, address, country: ABC COMPANY 55,17 STREET, EATON CENTRE TORONTO，CANADA 4.Means of transport and route (as far as known) Departure Date :2012.06.15 Vessel /Flight/Train/Vehicle No. DIEK335 V.007 Port of loading :GUANGZHOU PORT ,CHINA Port of discharge :TORONTO PORT,CANADA 5. For Official Use Only Preferential Tariff Treatment Given Under _______ Preferential Treatment Not Given (Please state reasons) …...………………………………………… Signature of Authorized Signatory of the Importing Country 6. Remarks 7.Item number (Max 20) 01 8. Marks and numbers on packages N/M 9. Number and kind of packages; description of goods CANE FURNITURE 10. HS code (Six digit code) 940151 11. Origin criterion CHINA 12. Gross weight, quantity (Quantity Unit) or other measures (liters,m3,etc) 21830KGS 432SETS 13. Number, date of invoice and invoiced value NDZ-123456 JUN.01,2012 USD228528.00 14．Declaration by the exporter The undersigned hereby declares that the above details and statement are correct, that all the goods were produced in （Country） CHINA and that they comply with the origin requirements specified in the FTA for the goods exported to （Importing country） NAN DAO ZHU CANE FURNITURE CO,LTD                                         吴艺娃 Place and date, signature of authorized signatory 15．Certification It is hereby certified, on the basis of control carried out, that the declaration of the exporter is correct. Place and date* , signature and stamp of certifying authority Certifying authority Tel: Fax: Address: ORIGINAL A Certificate of Origin under China-Chile Free Trade Agreement shall be valid for one year from the date of issue in the exporting coun