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Generalized System of References Certificate of Origin (Combined Declaration and Certificate)

1. PT. Ade Guruh Ardiyanto exported 20,000 pieces of men's coats from Indonesia to Louis Fashion Inc. in Hamburg, Germany. 2. The goods were shipped by sea from Indonesia to Germany on an unspecified date. 3. The certificate certifies that the exporter's declaration is correct and that the goods comply with origin requirements for goods exported to the UK under the generalized system of preferences.

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Ade Guruh
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52 views1 page

Generalized System of References Certificate of Origin (Combined Declaration and Certificate)

1. PT. Ade Guruh Ardiyanto exported 20,000 pieces of men's coats from Indonesia to Louis Fashion Inc. in Hamburg, Germany. 2. The goods were shipped by sea from Indonesia to Germany on an unspecified date. 3. The certificate certifies that the exporter's declaration is correct and that the goods comply with origin requirements for goods exported to the UK under the generalized system of preferences.

Uploaded by

Ade Guruh
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 DOCX, PDF, TXT or read online on Scribd
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CERTIFICATE OF ORIGIN

1.Goods consigned from (exporter business Reference No : 0001/JKT/2015


name, address, country)
PT. ADE GURUH ARDIYANTO A
JALAN RAYA DEMAK KM.9 SAYUNG DEMAK
CENTRAL JAVA, INDONESIA GENERALIZED SYSTEM OF REFERENCES
CERTIFICATE OF ORIGIN
(Combined declaration and certificate)
2. Goods consigned to (consigned’s name,
address, country)
LOUIS FASHION INC., FORM A
BURSTAH 42, 20457 HAMBURG Issued in Indonesia.
GERMANY (Country)

Sea notes overleaf


3. Shipped : by ……. 4. For Official use

Means of Transport and route (as far known) Isued restros pectrively
FROM : INDONESIA
TO : GERMANY

BY : SEA
Dated of shipped :

5. Item 6. Marks 7. Number and kind of 8. Origin 9. Gross 10. Number and date of
number and packages, description of goods criterion weight or invoice
number of other
package quantity
20.000 pgs contains of men,s GW = NO :
coat 11.000 171804128/MC/VI/2021
Sotton and polyser KGS
DATE : 17-07-21

11. Certification 12. Declaration by the exporter

It is hereby certified, on the basis of control The undersigned hereby declare that the above details and
carried out, that the declaration by the exporter statements are correct : that all the goods were
is correct

Produced in …………..

And that they comply with the origin requirements specified


for those goods in the generalized system of preferences
for goods exported to UK

Jakarta,
Place and date, signature of authorized signatory
Jakarta, 17 FEBRUARI
…..
……………………………………………………
Place and date, signature and stamp of certifing
authority

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