Combined Certificate Of Value And Of Origin And Invoice Of Goods Page 2

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IN ACCORDANCE WITH NIGERIAN GOVERNMENT NOTICE 1989 OF 1970
FORM C16
NIGERIA
Combined Certificate of Value and of Origin and Invoice of Goods for
Exportation to Nigeria
CERTIFICATE OF VALUE
I,
Of .
*Manufacture/Suppliers/Exporters of the goods enumerated in this invoice amounting to
hereby declare that I have the authority to make and sign this certificate on behalf of the aforesaid
*Manufacture/Suppliers/Exporters and that I have the means of knowing and I do hereby certify as follows:
(1) That this invoice is in all respect correct and contains a true and full statement of the price actually paid or to
be paid for the said goods, and the actual quantity thereof.
(2) That no different invoice of the goods mentioned in the said invoice has been or will be furnished to anyone.
(3) That no arrangement or understanding affecting the Purchase price of the said goods has been or will be made
or entered into between the said exporter and purchaser or by anyone on behalf of them either by way of
discount, rebate, compensation or in any manner whatever other than as fully shown on this invoice.
Date at
this _
________day of ___
(Signature) _____________________________________(Signature of
witness)_____________________________
Note: The person making the declaration should be a principal or a Manager, Chief Clerk, Secretary or responsible
employee.
*Delete the inapplicable
CERTIFICATE OF ORIGIN
I,
of .
*Manufacture/Suppliers/Exporters of the goods enumerated
in this invoice hereby declare that I have the
authority to make and sign this certificate on behalf of the aforesaid *Manufacture/Suppliers/Exporters and that I
have the means of knowing and I do hereby certify as follows:
(1) That all the goods mentioned in this invoice have been either wholly produced or manufactured in
(2) That all the goods mentioned in this invoice have been either wholly or partial produced or
manufactured in
(3) That as regards those goods only partially produced or manufactured.
(a) the final process or processes of manufacture have been performed in
___________
______
____
(b) the expenditure in material produced and/or labour performed in_____________ calculated
subject to qualification hereunder, in the case of all such goods is not less than 25 per cent of
the factory or works costs of all such goods in their finished state.*see note below.
(4) That in the calculation of such proportion of material produced and /or labour performed none of
the following items has been included or considered.

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