出口俄罗斯货物的普惠制原产地证明
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(英文)
Сертификат происхождения товара по форме ?А?
1. Goods consigned from (Exporter’s Reference No. TR-82
business name, address, country) GENERALIZED SYSTEM OF PREFERENCE
CERTIFICATE OF ORIGIN REPOTEC CO., LTD. IF NO 522-1 (Combined declaration and certificate) CHING PING
RD., CHUNG-HO CITY, TAIPEI HSIEN FORM A TAIWAN
Issued in TAIWAN/ China 2. Goods consigned to (Consignee’s name,
(country) address, country)
See notes overleaf
SILVIC JAKUBOWSKOGO 6 ST.
PETERBURG
3. Means of transport and route (as far as 4. For official use
known)
PER S. S. REGINA MAERSK V-9310
FROM KAOHSIUNG TAIWAN TO
BERLIN
4. Destination port
5. Item 6. Marks 7. Number and kind of 8. Origin 9. Gross 10. Number and date of
number and packages, description criterion weight or invoices
numbers of goods (see other REPOTEC of Notes quantity 930719 (IN packages COMPUTER PARTS overleaf) AUGUST 12, DIA.) MINI TOWER (603), 2002 BERLIN W/SPEED “p” P/O: DISPLAY+150W 1,286 930719 (LEGAL 200W) “p” PCS
C/NO.1-PSII POWER SUPPLY 1287 SPARE PARTS 1 PCS
MADE IN (FRONT PANEL) TAIWAN 1,287
PCS
11. Certification 12. Declaration by the explorer
it is hereby certified on the basis of control The undersigned hereby declares that the above
carried out that the declaration by the details
explorer is correct and statements are correct; that all the goods were
produced in TAIWAN/China CHAMBER OF COMMERCE TAIWAN
(country)
and that they comply with the requirements specified
for those goods in the Generalised System of
Preferences for goods exported to Signature of authorized officer issuing date (importing country)
TAIWAN/China
Place and date, signature of authorized signatory
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