ORIGINAL
GENERALIZEDSYSTEMOFPREFERENCESCERTIFICATE OF ORIGIN(Combined declaration and cericate)2.Goods consigned to (Consignee's name address country) FORMATHEPEOPLE'SREPUBLIC OF CHINAIssued in (oountry)See Notes overleaf3Means of transport and route (as faras known) 4.For offcial use5.ltem 6.Marks and 7. Number and kind of packages; description of goods 8.Origin 9.Gross 10.Number-wnu numbers of criterion weight and date ofber packages (see Notes overieaf) quantity arother invaices11.Certification 12.Declaration by the exporterIt is hereby cerified on the basis of control carried out that the The undersigned hereby declares that the above details and statementsdeclaration by the exporter is correct. are correct that allthe goods were CHINAproducedinand that they ply with the origin requirements specified for those (county)goods in the Generalized System of Preferences for goods exported toPaceanddatesignturendstamf erifyingatity Place and date signature and stamp of authorized signatory