Form A - Certificate Of Origin With Notes
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1
2Certificate of Origin
1. Goods consigned from (Exporter's business name,
Reference No
address, country)
GENERALISED SYSTEM OF PREFERENCES
CERTIFICATE OF ORIGIN
(Combined declaration and certificate)
FORM A
2. Goods consigned to (Consignee's name, address,
country)
Issued in
(country)
See Notes overleaf
3. Means of transport and route (as far as known)
4. For official use
5. Item
6. Marks
7. Number and kind of
8. Origin
9. Gross
10. Number
number
and
packages, description of
criterion
weight or
and date of
number
goods
(see Notes
other
invoices
of
overleaf)
quantity
packages
11. Certification
12. Declaration by the exporter
It is hereby certified, on the basis of control
The undersigned hereby declares that the above details
carried out, that the declaration by the exporter is
and statements are correct; that all the goods were
correct.
produced in
(country)
and that they comply with the origin requirements
specified for those goods in the Generalised 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
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