ANNEX 3-D MODEL FORMAT
KOREA-AUSTRALIA FREE TRADE AGREEMENT CERTIFICATE OF ORIGIN
|Please Print or Type||1. Issuing number :|
|2. Exporter- name and contact details :
3. Blanket period for multiple shipments :
From : (DD/MM/YYYY) To : (DD/MM/YYYY)
|4. Producer- name and contact details (optional field) :||5. Importer - name and contact details (optional field) :|
6. Description of good(s)
(including quantity, invoice number or other unique
reference number where appropriate) :
|7. Harmonized System code (six digits) :||8. Preference criterion :|
|9. Observations (optional field) :|
10. Declaration :
I certify that :
- The information in this document is true and accurate and I assume the responsibility for proving such representations.
I understand that I am liable for any false statements or material omissions made on or in connection with this document.
- I agree to maintain, and present upon request, documentation necessary to support this Certificate, and
to inform, in writing, all persons to whom the Certificate was given of any changes that would affect the
accuracy or validity of this Certificate.
- The goods originate in the territory of one or both Parties and comply with the origin requirements
specified for those goods in the Korea Australia Free Trade Agreement.
This Certificate consists of ______ pages, including all attachments.
|11.Signature :||Company or Authorised Body :|
|Name :||Title :|
|Date :||Contact details :|