ORIGINAL
1.    Goods consigned from (Exporter's business name, address, country)
export declaration
Reference No.
DCFJOM970603
  GOOD FRIEND ARTS CRAFTS IMP&EXP.CO. 
GENERALIZED SYSTEM OF PREFERENCES
CERTIFICATE OF ORIGIN
(Combined declaration and certificate)
2.    Goods consigned to (Consignee's name, address, country)
FORM A
INTERNTATINAL  TRADING  AND  RE-EXPORT  CO.(ZERKA FREE ZONE)P.O.BOX1147.AMMAN-JORDAN
Issued in
THE PEOPLE'S REPUBLIC OF CHINA
(country)
See Notes overleaf
3    Means of transport and route (as far as known)
4.    For official use
FROM CHAOZHOU TO AQABA BY SEA
JORAN
JORAN
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.    Number
and date of
in
N/M
ALL IN 4 ASSORTED COLORS,LIGHT BLUE,RED,PINK  AND  VIOLET
”EVA”SLIPPER MODEL
DOZT SIZE 36-40
“EVA”SLIPPER MODEL
6405200000
24000PAIRS
24000PAIR
NO:IV100104
DATE:2010-01-04
11.    Certification
It is hereby certified, on the basis of control carried out, that the declaration by the exporter is correct.
12.    Declaration by the exporter
The undersigned hereby declares that the above details and statements are correct, that all the goods were
produced in
CHINA
STAMP&SIGNATURE
(country)
and that they comply with the origin requirements specified for those goods in the Generalized System of Preferences for goods exported to
CHAOZHOU,
CHAOZHOU,
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Place and date, signature and stamp of certifying authority
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Place and date, signature and stamp of authorized signatory

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