Приложение 4 - 1. Сертификат происхождения (форма простая) / Annex 4 - 1. Certificate of origin (form eas)

ANNEX 4 - 1

CERTIFICATE OF ORIGIN (FORM EAS)

1. Exporter (business name, address, country)			4. N ________ EAEU-SINGAPORE FTA Certificate of Origin (Form EAS) Issued in For submission to _________________________________ (country)
2. Importer/Consignee (business name, address, country)
3. Means of transport and route (as far as known) Departure date Vessel's name/Aircraft etc. Port of Discharge			5. For official use
6. Items number	7. Marks, number and kind of packages	8. Description of goods (including HS code)	9. Origin criterion	10. Quantity of goods	11. Number and date of invoice
12. Certification It is hereby certified, on the basis of control carried out, that the declaration by the applicant is correct Place    Date    Signature    Stamp			13. Declaration by the applicant The undersigned hereby declares that the above details are correct, that all goods were produced in _________________________________ (country) and that they comply with the rules of origin as provided in Chapter 4 (Rules of Origin) of the EAEU-Singapore FTA Place    Date    Signature    Stamp
14. Third Party Invoicing De Minimis Accumulation Asian Food Products Partial Cumulation