Приложение 5а. Certificate of origin Form CT-2

Приложение 5а

1. Consignor/exporter (name and address)					4. N____________ Certificate of origin Form CT-2
2. Consignee/importer (name and address)					Issued in ________________________________ (country) For submission to ________________________________ (country)
3. Means of transport and route (as far as known)					5. For official use
6. N	7. Number and kind of packages		8. Description of goods			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 ............................................................................					13. Declaration by the applicant The undersigned hereby declares that the above details are correct: that all goods were produced or underwent sufficient processing in ________________________________ (country) and that they comply with the origin requirements specified for this goods ......................................................................
Signature		Date		Stamp	Signature		Date		Stamp

ADDITIONAL LIST OF CERTIFICATE OF ORIGIN N _____________
Form CT-2

6. N	7. Number and kind of packages		8. Description of goods			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 ............................................................................					13. Declaration by the applicant The undersigned hereby declares that the above details are correct: that all goods were produced or underwent sufficient processing in _________________________________ (country) and that they comply with the origin requirements specified for this goods ......................................................................
Signature		Date		Stamp	Signature		Date		Stamp