1. Goods consigned from (exporter's business name, address, country)
Reference No
GENERALIZED SYSTEM OF PREFERENCES
CERTIFICATE OF ORIGIN
(Combined declaration and certificate)
FORM A
REPUBLIC OF KOREA
Issuedin
(country)
See notes overleaf
2. Goods consigned to (consignee's name, address, countuy)
3. Means of transport and route (as far as known)
4. For official use
5. Item
num
ber
6. Marks and
numbers of
packages
7. Number and kind of packages; description of goods
8. Origin
criterion
(see notes
overleaf)
9. Gross weight
or other
quantity
10. Nomber
and date of
invoices
11. Certification
It is hereby ceritified, on the basis of control carried out,that
the declaration by the exporter is correct.
Place and date, signature and stamp of certifying authority
12. Declaration by the exporter
The undersigned hereby declares that the above details and statements are correct; that all the goods were REPUBLIC OF KOREA
produced in
(country)
and that they comply with the origin requirements specified for those goods in the generalized system of preferences for goods exported to
(importing country)
Place and date, signature of authorized signatory |
2007.12.04
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