SHENZHEN KELAITE INDUSTRY CO 1.Goods consigned from (Exporter’s business name,address, country) IMPORT & EXPORT CO.,LTD. SHENZHEN HAIFU O/B…贵公司抬头 Reference No. GENERALIZED SYSTEM OF PREFERENCES CERTIFICATE OF ORIGIH (Combined declaration and certificate) FORM E Lssued in THE PEOPLE’S REPUBLIC OF CHINA (counrry) See Notes overlea 2.Goods consigned to (Consignee’s name, address.country)收货客户/地址 如无详细地址，则打上To Order 3.Means of transport and oute (as far known) Departure date: 出货日期 vessel’s name /Aircraft etc. 运输方式 Port of discharge: 卸货港 英文描述自运输方式及目的港 4.For official use □ Preferential Treatment Guveb Under ASEAN-CHINA Free Trade Area Preferential Tariff □ Preferential Treatment Not given(Please state Reason/s) 5.ltem num- ber 序号 6.Marks and numbers of packages 唛头 7.Number and kind of packages;description of goods (including quantity where appropriate and HS number of the importing country) 品名 HS编码 其它备注信息，如提单号等 8.Origin criterion (See Notes Overleaf) 原产地
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9.Gross weight or other quantity and value(FOB) 数量 重量 货值信息 10.Number and date of invoices 发票号 发票日期 11.Declaration by the exporter The undersigned hereby declares that the above details and state- Ments are correct;that all the goods were produced in CHINA (country) and that they comply with the origin requirements specified for those goods in the Generalized System of Preferences for goods ex- ported to 目的国 (importing country) Place and date,signature of authorized signatory SHENZHEN 日期,2010 12.Certification It is hereby vertified,on the basis of control carried out.that The declaration by the exporter is correct Place and date,signature and stam of certifiying authority SHENZHEN 日期,2010 实样图： 更多资料http://blog.sina.com.cn/u/1600274793
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