Form E 格式中英文

1.Goods consigned from (Exporter’s business name,address, Country)发货人 SHENZHEN CITY VICTORY PROSPER IN BUSINESS SOURCE IMPORT AND EXPORT LTD. 2.Goods consigned to (Consignee’s name,address,country)收货人

Certificate no.:

ASEAN-CHINA FREE TRADE AREA PREFERENTIAL TARIFF CERTIFICATE OF ORIGIN (Combined Declaration and Certificase) FORM E Issued in THE PEOPLE’S REPUBLIC OF CHINA (Country) See Notes overleaf

3.Means of transport and route (as far as known)路线 Departure Date 日期 Vessel’s name/Aircraft etc. 船名航次 Port of discharge 目的地 5.Item Numb er 8.Marks and numbers on package 唛头

4.For official use

9.Number and type of packagers,description of goods (including quantity where appropriate and HSnumber of the importing Country)品名及箱数及六位商品编码

8.Origin criterion (see Notes overleaf

9.Gross weight or Other quantity and value (FOB) 数 量及 FOB 金额

10.Number and date of invoices 发 票号及日期

“X” “40%” 以 上

11.Declaration by the exporter

12.Certification

Form E 格式中英文

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