Term Project paper

Certificate of Origin Template

Certificate of Origin Exporter Name and Address Blanket Period: (DD/MM/YYYY)

FROM:

Tax Identification Number TO: Producer Name and Address Importer Name and Address:

Tax Identification Number: Tax Identific a t ion Number: Description of Good(s) TARRIF PREFERENCE PRODUCER NET CO UNTRY

CLASSIFICATION CREITERION COST OF NUMBER ORIGIN

I CERTIFY THAT:

• Information prov ided in this certificate is based on facts and is accurate and I assume the responsibility for proving such

representations. I understand that I am liable for any false sta tement or material omission made on or in concern with this

document.

• I agree to maintain and present upon request documen1ation necessary to support this certif icate and to inform, in

w rit ing, al persons to w hom this certif icate w as given of any changes that w ould af fect accuracy or validity of this

certif icate.

• This certif icate consists of ________ pages including all attachments

Authorized Signature: COM PANY: Name: (Print or Type) TITLE: Date: DD/MM/YYYY I Ph: xxxxxxxxxxxxxxx Fax: xxxxxxxxxxxxxxxxxx I Customs Form:

e.g. "free"

1. Period From:
2. Exporter Name and Address:
3. Importer Name and Address:
4. Description of Product:
5. Period To:
6. 10-digit HS number:
7. Country:
8. Name:
9. Company name:
10. Title:
11. Duty rate (e:
1. g:
1. , free):