GLOBAL SYSTEM OF TRADE PREFERENCES

Goods consigned from (Exporter's business name, address, country)

Goods consigned to (consignee's name, address, country)

Means of transport and route(as for as known)

 FROM

 TO

 BY 

 ON BOARD DATE

For official use

Tariff Item num-ber

marks and numbers of package

Number and kind of packages ;

  description of goods

Origin criterion (see notes overleaf)

Gross weight or other quantity

Number and date of invoice 

Declaration by the exporter

The undersigned hereby declares that the above de

tails and statements are correct; that all the goods

were

produced in

and that they comply with the origin requirements

specified for those goods in the Global System of

Trade  Preferences for goods exported to

Place and date, signature of authorized Signatory

Certification

It is hereby certified, on the basis of control carried

out, that the declaration by the exporter is correct 

GLOBAL SYSTEM OF TRADE PREFERENCES.xls