Form A - CERTIFICATE OF ORIGIN
1. Goods consigned from (Exporter's
Reference No.
business name, address, country)
GENERALIZED SYSTEM OF PREFERENCES
CERTIFICATE OF ORIGIN
(Combined declaration and certificate)
FORM A
2. Goods consigned to (Consignee's name,
Issued in ....................................................................
address, country)
(country)
See the instructions.
3. Means of transport and route (as far as known)
4. For official use
5. Item
6. Marks and
7. Number and kind of packages:
8. Origin criterion
9. Gross weight
10. Number and
number
numbers
description of goods
(See instructions)
or other
date of
of packages
quantity
invoices.
11. Certification
12. Declaration by the exporter
It is hereby certified, on the basis of control carried
The undersigned hereby delcares that the above details and
out, that the declaration by the exporter is correct.
statements are correct: that all the goods were produced in
..................................................................
(country)
and that they comply with the original requirements specified
for those goods in the Generalized System of Preferences for
goods exported to
..................................................................
(importing country)
................................................................................................
......................................................................................
Place and date, signature of authorized signatory
Place and date, signature and stamp of certifying authority.