Mẫu số 02 - Phụ lục III
CERTIFICATE OF ELIGIBILITY
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Certificate number: (For certificate issuing authority) |
Pages: / |
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1. Name, Address of Exporter:
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2. Name, Address of Importer or Consignee: |
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3. Exporting Country/Region:
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4. Means of Transport:
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5. Place of Loading: |
6. Place of Destination: |
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7. Item No. |
8. Marks, numbers and kind of packages; decription of goods (including HS number of Importing Country) |
9. Quantity of goods |
10. Description of the material on the Short Supply List of Products used in the manufacture of the good exported |
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11. Declaration by the exporter The undersigned hereby declares that the above details and statements are correct; (Place and date, signature of authorised signatory)
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12. Place and date, signature of Authorized officer and certificate isuing authority |
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13. Remarks:
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