090404 制普惠制产地证 FORM-A

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ORIGINAL
1.Goods consigned from (Exporter's business name, address, country)
Reference No.
DCFJOM970603
GOOD FRIEND ARTS CRAFTS IMP&EXP.CO.
CERTIFICATE OF ORIGIN
(Combined declaration and certificate)
2.Goods consigned to (Consignee's name, address, country)
INTERNTATINAL TRADING AND RE-EXPORT CO.(ZERKA FREE ZONE)P.O.BOX1147.AMMAN-JORDAN
CHAOZHOU,
----------------------------------------------------------------------------------------------------------
Place and date, signature and stamp of certifying authority
ber
6.Marks and
numbers of
packages
7.Number and kind of packages; description of goods
8.Origin
criterion
(see Notes
overleaf)
9.Gross
weight
or other
quantity
10.Number
12.Declaration by the exporter
The undersigned hereby declares that the above details and statements are correct, that all the goods were
produced in
STAMP&SIGNATURE
(cHale Waihona Puke Baiduuntry)
and that they comply with the origin requirements specified for those goods in the Generalized System of Preferences for goods exported to
CHAOZHOU,
NO:IV100104
DATE:2010-01-04
11.Certification
It is hereby certified, on the basis of control carried out, that the declaration by the exporter is correct.
----------------------------------------------------------------------------------------------------------
Place and date, signature and stamp of authorized signatory
and date of
in
N/M
ALL IN 4 ASSORTED COLORS,LIGHT BLUE,RED,PINK AND VIOLET
”EVA”SLIPPER MODEL
DOZT SIZE 36-40
“EVA”SLIPPER MODEL
6405200000
24000PAIRS
24000PAIR
Issued in
(country)
See Notes overleaf
3Means of transport and route (as far as known)
4.For official use
FROM CHAOZHOU TO AQABA BY SEA
JORAN
JORAN
5.Item num-
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