ࡱ> orq7 RbjbjUU <   4qh4 t$"h*l?6  DN2 CERTIFICATE OF ORIGIN (SAMPLE ONLY) 1. Exporter s name, address and country: Certificate No.: CERTIFICATE OF ORIGIN Form for China-Georgia Free Trade Agreement Issued in: 2. Producer s name, address and country : 3. Importer s name, address and country: 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 number7. Marks and numbers on packages8. Number and kind of packages; description of goods9. HS code (6-digit code)10. Origin criterion11.Gross or net weight or other quantity (e.g. Quantity Unit, litres, m3.)12.Number and date of invoice  13. Declaration by the exporter or producer The undersigned hereby declares that the above stated information is correct, and that all the goods are produced in  (Country) and that they comply with the origin requirements specified in the Free Trade Agreement for the goods exported to  Importing country) Place, date and signature of authorized 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 China  Georgia Free Trade Agreement.  Place and date, signature and stamp of the Authorized Body  Overleaf Instruction Box 1: State the full legal name and address of the exporter in Georgia or China. Box 2: State the full legal name and address of the producer (including country), if known. If more than one producer s good is included in the certificate, list the additional producers, including names and addresses (including country). If the exporter or the producer wish the information to be confidential, it is acceptable to state  Available to the competent authority or authorised body upon request . If the producer and the exporter are the same, please complete the box with  SAME . Box 3: State the full legal name and address of the importer in Georgia or China. Box 4: Complete the means of transport and route and specify the departure date, transport vehicle number, and port of loading and discharge, as far as known. Box 5: The Customer s Order Number, Letter of Credit Number, among others, may be included. If the invoice is issued by a non-Party operator, information such as the name, address and country of the operator issuing the invoice shall be indicated herein. Box 6: State the item number. Box 7: State the shipping marks and numbers on packages when such marks and numbers exist. If the shipping marks are images or symbols, state  IMAGE OR SYMBOL(I/S) . Otherwise state  NO MARKS AND NUMBERS(N/M) . Box 8: The number and kind of packages shall be specified. Provide a full description of each good. The description should be sufficiently detailed to enable the products to be identified by the Customs Officers examining them and relate it to the invoice description and to the HS description of the good. If the goods are not packed, state  in bulk . When the description of the goods is finished, add  *** (three stars) or  \  (finishing slash). Box 9: For each good described in Box 8, identify the HS tariff classification (a six-digit code). Box 10: For each good described in Box 8, state which criterion is applicable, according to the following instructions. The rules of origin are contained in Chapter 3 (Rules of Origin and Implementation Procedures) and Annex II-A (Product Specific Rules of Origin) of the China-Georgia Free Trade Agreement. Origin CriterionInsert in Box 10The good is wholly obtained or produced in the territory of a Party in accordance with Article 3 (Goods Wholly Obtained or Produced) of Chapter 3 (Rules of Origin).WOThe good is produced in a Party exclusively from materials whose origin conforms to the provisions of Chapter 3 (Rules of Origin).WPThe good is produced from non-originating materials in a Party, provided that the goods conform to a regional value content of no less than 40%.Actual percentage of CGFTA value content, example  40% The good is produced in the territory of one or both Parties, using non-originating materials that comply with the applicable product specific rule; and meets the other applicable provisions of Chapter 3 (Rules of Origin).PSR Box 11: State gross or net weight in kilograms or other units of measurement for each good described in Box 8. Other units of measurement (e.g. volume or number of items) which would indicate exact quantities may be used where customary. Box 12: The invoice number and date should be shown here. Box 13: The box must be completed by the exporter or producer. Insert the place, date and the signature of a person authorised by the exporter or producer. Box 14: The box must be completed, signed, dated and stamped by the authorised person of the authorised body. 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