ORIGINAL
1.Exporter Certificate No.
CERTIFICATE OF ORIGIN
OF
THE PEOPLE'S REPUBLIC OF CHINA
2.Consignee
3.Means of transport and route 5.For certifying authority use only
4.Country / region of destination
6.Marks and numbers 7.Number and kind of packages; description of goods 8.H.S.Code 9.Quantity 10.Number
and date of
invoices
11.Declaration by the exporter
The undersigned hereby declares that the above details and statements are correct, that all the goods were produced in China and that they comply with the Rules of Origin of the People's Republic of China. 12.Certification
It is hereby certified that the declaration by the exporter is correct.
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Place and date, signature and stamp of authorized signatory --------------------------------------------------------------------
Place and date, signature and stamp of certifying authority
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