附件：原产地证书格式以及填制说明            Original
1. Exporter (full name, address and country):
Certificate No.:
CERTIFICATE OF ORIGIN
DUTY-FREE TREATMENT
Granted by China
(Combined Declaration and Certificate)
Issued in_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
( See Instruction Overleaf )
2. Producer’s name and address, if known:
3. Consignee (full name, address and country):
For official use only:
4. Means of transport and route (as far as known)
Departure date
Vessel /Flight/Train/Vehicle No.
Port of loading
Port of discharge
5.Remarks
6.Item number
7.Marks and numbers on packages
8.Number and kind of packages; Description of goods
9. HS Code (6-digit)
10. Origin Criterion
11. Gross weight, quantity (quantity unit) or other measures (litres, m3,etc)
12. Number, date of
invoice and
invoiced value
13. Declaration by the exporter
The undersigned hereby declares that the above
details and statements are correct, that all the goods were produced in
……………………………………………
(country)
and that they comply with the origin requirements
specified for these goods under the Duty-Free Treatment exported to China.
………………………………………………
Place and date, signature of authority signatory.
14.Certification
It is hereby certified, on the
basis of control carried out,
that the declaration by the
exporter is correct.
…………………………
Place and date, signature and stamp of issuing body.
15. Customs verification
This is to certify that the goods declared for exportation correspond to what is stated under this certificate
…………………………
Place, date, signature and stamp of exporting customs authority.
Page 1 of
Certificate No:
6.Item number
7.Marks and numbers on packages
8.Number and kind of packages; Description of goods
9. HS Code (6-digit)
10. Origin Criterion
11. Gross weight, quantity (quantity unit) or other measures (litres, m3,etc)
12. Number, date of
invoice and
invoiced value
13. Declaration by the exporter
The undersigned hereby declares that the above
details and statements are correct, that all the goods were produced in
……………………………………………
(country)
and that they comply with the origin requirements
specified for these goods under the Duty-Free Treatment exported to China.
export declaration
………………………………………………
Place and date, signature of authority signatory
14.Certification
It is hereby certified, on the
basis of control carried out,
that the declaration by the exporter is correct.
…………………………
Place and date, signature and stamp of issuing authority
15. Customs verification
This is to certify that the goods declared for exportation correspond to what is stated under this certificate
…………………………
Place, date, signature and stamp of exporting customs authority.
Page 2 of
Overleaf Instruction
Certificate No.: Serial number of Certificate of Origin assigned by the issuing body.
Box 1:  State the full legal name, address (including country) of the exporter and the exporter should be in the beneficiary country.
Box 2:  State the full legal name, address (including country) of the producer and the producer should be in the beneficial country. If more than one producer’s good is included in the certificate, list the additional producers, including name, address (including country). If the exporter or the producer wishes the information to be confidential, it is acceptable to state “Available to the authorized body upon request”. If the producer and the exporter are the same, please complete field with “SAME”. If the producer is unknown, it is acceptable to state "UNKNOWN".
Box 3:  State the full legal name, address (including country) of the consignee, and the co
nsignee should be in the customs territory of China.
Box 4:  Complete the means of transport and route and specify the departure date, transport vehicle No., port of loading and discharge.
Box 5:  Any additional information such as Customer’s Order Number, Letter of Credit Number, etc. may be included.
Box 6:  State the item number.
Box 7:  State the shipping marks and numbers on the packages.
Box 8:  Number and kind of package shall be specified. Provide a full description of each good. The description should be sufficiently detailed to enable the products to be identified by the Customs Officers examining them and relate it to the invoice description and to the HS description of the good. If goods are not packed, state “in bulk”. When the description of the goods is finished, add “***” (three stars) or “ \ ” (finishing slash).
Box 9:  For each good described in Box 9, identify the HS tariff classification of China to six digits.
Box 10:  If the goods qualify under the Rules of Origin, the exporter must indicate in Box 10 of this form the origin criteria on the basis of which he claims that his goods qualify for preferential tariff treatment, in the manner shown in the following table:
The origin criteria on the basis of which the exporter claims that his goods qualify for Duty-Free Treatment
Insert in Box 10
The good is wholly obtained or produced in the territory of the beneficiary country as set out and defined in Rule 4.
WO
When the good is subject to “ad valorem percentage” no less than 40% or CTH.
CTH or Ad Valorem Percentage (40%)
When the good is subject to a requirement stipulated in PSR, indicate the specified criteria.
Criterion as specified in PSR.
Box 11:  Gross weight in kilograms should be shown here. Other units of volume or number of items which would indicate exact quantities may be used when customary.

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