Mẫu số 02 - Phụ lục III
CERTIFICATE OF ELIGIBILITY
Certificate number: (For certificate issuing authority) | Pages: / |
1. Name, Address of Exporter: | 2. Name, Address of Importer or Consignee: |
3. Exporting Country/Region: | 4. Means of Transport: |
5. Place of Loading: | 6. Place of Destination: |
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 |
11. Declaration by the exporter The undersigned hereby declares that the above details and statements are correct; (Place and date, signature of authorised signatory) | 12. Place and date, signature of Authorized officer and certificate isuing authority | ||
13. Remarks: | |||