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Form E: Asean-China Free Trade Area Preferential Tariff Certificate of Origin (Combined Declaration and Certificate)

This document is a certificate of origin for 480 bags of pyrite shipped from Tongling, China to Jakarta, Indonesia by sea. It contains information about the exporter, consignee, means of transport, item details including description, origin criteria, weight, and invoice. The exporter declares that the products were produced in China and meet the origin requirements to qualify for preferential tariff treatment under the ASEAN-China Free Trade Area agreement. The certifying authority certifies that the exporter's declaration is correct based on control carried out.

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Azzam Yasjudan
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100 views1 page

Form E: Asean-China Free Trade Area Preferential Tariff Certificate of Origin (Combined Declaration and Certificate)

This document is a certificate of origin for 480 bags of pyrite shipped from Tongling, China to Jakarta, Indonesia by sea. It contains information about the exporter, consignee, means of transport, item details including description, origin criteria, weight, and invoice. The exporter declares that the products were produced in China and meet the origin requirements to qualify for preferential tariff treatment under the ASEAN-China Free Trade Area agreement. The certifying authority certifies that the exporter's declaration is correct based on control carried out.

Uploaded by

Azzam Yasjudan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Triplicate

1.Products consigned from(Exporter’s business name,address, Reference No. E206836466431001


country)
TONGLING FULIU INDUSTRIAL CO.,LTD. NO.11, BUILDING 69,
NEW GARDEN VILLAGE, TONGLING,ANHUI,CHINA
ASEAN-CHINA FREE TRADE AREA
PREFERENTIAL TARIFF
CERTIFICATE OF ORIGIN
2.Products consigned to (Consignee's name,address,country) (Combined Declaration and Certificate)
PT.ALFA NABILA TEHNIK
JL. SEKAR KEMUNING A3 RT FORM E
003/ RW 003 KEL.KARYAMULYA 非有效证书
KEC. KESAMBI KOTA CIREBON-INDONESIA Issued in THE PEOPLE'S REPUBLIC OF CHINA
(Country)
See Overleaf Notes
3.Means of transport and route (as far as known) 4.For Original use
Verification:origin.customs.gov.cn
Departure date JUN. 29,2020 □ Preferential Treatment Given

Vessel's name/Aircraft etc. HUAHAI166 20032E

Port of Discharge JAKARTA INDONESIA


□ Preferential Treatment Not Given(Please state reason/s)

FROM TONGLING,CHINA TO JAKARTA INDONESIA BY SEA.

--------------------------------------------------------
Signature of Authorised Signatory of the Importing Party
5.item 6.Marks and 7.Number and type of packages, description 8.Origin criteria 9.Gross weight or net 10.Number,
number numbers on of products (including quantity where (see Overleaf weight or other quantity, date of
packages appropriate and HS number in six digit code) Notes) and value (FOB) only lnvoices
when RVC criterion is
applied
1 N/M FOUR HUNDRED AND EIGHTY (480) BAGS OF "PE" 960960KGS G.W. FL2020-6-22
PYRITE(FERRO SULPHUR) JUN. 22,2020
SIZE:100-200MESH
S:47%MIN,FE:42%MIN.
SIO2:3.24%MAX,AS:0.08%MAX.
PB:0.14%MAX,H2O:3%MAX.
H.S CODE: 2502.00
*** *** *** *** ***

11.Declaration by the exporter 12.Certification


The undersigned hereby declares that the above details
it is hereby certified on the basis of control carried out,that the
and Statement are correct,that all the products were produced in
declaration by the exporter is correct
CHINA
-------------------------------------------------
(Country)
and that they comply with the origin requirements specified for
these products in the Rules of Origin for the ACFTA for the
products exported to

INDONESIA
---------------------------------------------
(Importing Country)

Hefei, China,JUL. 01,2020


---------------------------------------------
Place and date，signature of authorised signatory
13.
□ Issued Retroactively □Exhibition ---------------------------------------------------------
□ Movement Certificate □ Third Party Invoicing Place and date,signature and stamp of certifying authority

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