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中國 - 智利自由貿易區協定原產地證書樣式

1.Exporter’s name, address, country:

Certificate No.:

CERTIFICATE OF ORIGIN

Form F for China-Chile FTA

Issued in ____________

(see Instruction overleaf)

2. Producer’s name and address, if known:

3.Consignee’s name, address, country:

4.Means of transport and route (as far as known)

Departure Date

Vessel /Flight/Train/Vehicle No.

Port of loading

Port of discharge

5. For Official Use Only

Preferential Tariff Treatment Given Under _______

Preferential Treatment Not Given (Please state reasons)

…...…………………………………………

Signature of Authorized Signatory of the Importing Country

6. Remarks

7.Item number

(Max 20)

8. Marks and numbers on packages

9. Number and kind of packages; description of goods

10.
HS code

(Six digit code)

 

11. Origin criterion

12. Gross weight, quantity
(Quantity Unit) or other measures (liters,m3,etc)

13.
Number, date of invoice and invoiced value

14. Declaration by the exporter

The undersigned hereby declares that the above details and statement are correct, that all the goods were produced in

(Country)

and that they comply with the origin
requirements specified in the FTA for the goods exported to

(Importing country)

Place and date, signature of authorized signatory

15. Certification

It is hereby certified, on the basis of control carried out, that the declaration of the exporter is correct.

Place and date, signature and stamp of certifying authority

Certifying authority

Tel:                  Fax:

Address:

             

* A Certificate of Origin under the China-Chile FTA is valid for one year from the date of issue in the exporting country.

Overleaf Instruction

Box 1:  State the full legal name, address (including country) of the exporter.

Box 2:  State the full legal name, address (including country) of the producer. 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 competent governmental authority 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.

Box 4:  Complete the means of transport and route and specify the departure date, transport vehicle No., port of loading and discharge.

Box 5:  The customs authorities of the importing country must indicate (√) in the relevant boxes whether or not preferential tariff treatment is accorded.

Box 6:  Customer’s Order Number, Letter of Credit Number, and etc. may be included if required. If the invoice is issued by a non-Party operator, the name, address of the producer in the originating Party shall be stated herein.

Box 7:  State the item number, and item number should not exceed 20.

Box 8:  State the shipping marks and numbers on the packages.

Box 9:  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 10:              For each good described in Box 9, identify the HS tariff classification to six digits.

Box 11: If the goods qualify under the Rules of Origin, the exporter must indicate in Box 11 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 preferential tariff treatment

Insert in Box 11

Goods wholly obtained

P

General rule as ≥40% regional value content

RVC

Products specific rules

PSR

Box 12:              Gross weight in Kilos should be shown here. Other units of measurement e.g. volume or number of items which would indicate exact quantities may be used when customary.

Box 13:              Invoice number, date of invoices and invoiced value should be shown here.

Box 14:              The field must be completed, signed and dated by the exporter. Insert the place, date of signature.

Box 15:              The field must be completed, signed, dated and stamped by the authorized person of the certifying authority. The telephone number, fax and address of the certifying authority shall be given.

 

中文文本僅供參考

1.出口商的名稱、地址、國家

 

 

證書號:

原產地證書

中國-智利自由貿易區FORM F

簽發國______________

(填制方法詳見證書背頁說明)

 

2. 生產商的名稱、地址,在已知情況下

 

 

3. 收貨人的名稱、地址、國家

 

5. 供官方使用

¨可享受________自貿區優惠待遇

¨不能享受_________自貿區優惠待遇,理由:

…………………………………………

 

進口國官方機構的授權人手簽

 

4. 運輸方式及路線(就所知而言)

離港日期

船隻/飛機/火車/貨車編號

裝貨口岸

卸貨口岸

 

 

6. 備註:

 

7. 項目號(最多20項)

8. 嘜頭及包裝號

9. 包裝數量及種類,商品名稱

10.
HS 編碼

(以六位編碼為準)

11.
原產地標準

 

12.
毛重、數量(數量單位)或其他計量單位

(升、立方米等)

13. 發票號、發票日期及發票價格

 

 

 

 

 

14. 出口商申明

下列簽字人證明上述資料及申明正確無誤,所有貨物產自

(XX國家)

且符合自貿區原產地規則的相關規定,該貨物出口至

(XX進口國)

申報地點、日期及授權簽字人的手簽

15. 證明

根據所實施的監管,茲證明上述出口商的申報正確。

地點、日期*、簽字及簽證機構印章

簽證機構

電話                傳真

地址

 
             

 

背頁說明

第一欄:  應填寫出口商詳細的依法登記的名稱、地址(包括國家)。

第二欄:  在已知的情況下填寫生產商詳細的依法登記的名稱、地址(包括國家)。如果證書包含一個以上生產商的商品,應該列出其他生產商的詳細名稱、位址(包括國家)。如果出口商或生產商希望對資料予以保密,可以填寫“應要求提供給簽證機構(Available to competent governmental authority upon request)”。如果生產商和出口商相同,應填寫“相同(SAME)”。如果不知道生產商,可填寫“不知道(UNKNOWN)”。

第三欄:  應填寫收貨人詳細的依法登記的名稱、地址(包括國家)。

第四欄:  應據所知填寫運輸方式及路線、詳細說明離港日期、運輸交通工具的編號、裝貨口岸和卸貨口岸。

第五欄:  不論是否給予優惠待遇,進口方海關必須在相應欄目標注(ü)。

第六欄:  如有要求可以填寫顧客順序號、信用證號等。如果發票是由非締約方開出的,應在此欄標注原產國生產商的名稱、地址和國家。

第七欄:  應填寫項目號,但不得超過20項。

第八欄:  應填寫嘜頭及包裝號。

第九欄:  應詳細列明包裝數量及種類。對每種貨物提供詳細的貨物描述,以便於查驗的海關關員可以識別。貨物描述應與發票描述及貨物的協調製度編碼相符。如果是散裝貨,應註明“散裝”。當貨物描述結束時,加上“***”(三顆星)或“\”(結束斜線符號)。

第十欄:   應對應第九欄中的每種貨物填寫協調製度編碼,以六位編碼為準。

第十一欄: 若貨物符合原產地規則,出口商必須按照下列表格中規定的格式,在本證書第十一欄中標明其貨物申報享受優惠待遇所根據的原產地標準。

出口商申報其貨物享受
優惠待遇所根據的原產地標準

填入第11欄

(1)    在出口方完全獲得的產品

“P”

(2)    符合基本標準,即區域價值成分大於或等於40%的產品

“RVC”

(3)    符合產品特定原產地規則的產品

“PSR”

第十二欄: 毛重應填寫“千克”,可依照慣例,使用其他計量單位例如體積、數量等來精確地反映量。

第十三欄: 應填寫發票號、發票日期及發票價。

第十四欄: 本欄必須由出口商填寫、簽名並填寫日期。且應該填寫簽名的地點及日期。

第十五欄: 本欄必須由簽證機構的授權人員填制、簽名、填寫簽證日期並蓋章。並應提供簽證機構的電話號碼,傳真及地址。


* 中國-智利自由貿易區協定項下的原產地證書應在自出口方簽發之日起一年內有效。

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