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Certificate of Origin Form

The document is a certificate of origin template that includes fields for exporter and consignee details, transportation details, description of goods, certification, and declaration sections.

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Dhirendra Kumar
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620 views1 page

Certificate of Origin Form

The document is a certificate of origin template that includes fields for exporter and consignee details, transportation details, description of goods, certification, and declaration sections.

Uploaded by

Dhirendra Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CERTIFICATE OF ORIGIN Corporate Identification Number (CIN)

U91110TG1964NPL001030
Exporter
No
CERTIFICATE OF ORIGIN
(NON PREFERENTIAL)

(Combined declaration and certificate)


Consignee
issued in India

Pre-Carriage by Place of Receipt by Pre-Carrier


The Federation of Telangana
Chambers of Commerce and Industry
Vessel / Flight No. Port of Loading Federation House,
Red Hills, Hyderabad - 500 004.
Telangana, INDIA
Port of Discharge Final Destination Phones : +91-040-23395515 to 22 ( 8 Lines )
Fax : +91-040-23395525
E-mail : [email protected], Website : www.ftcci.in

Marks & No. No. & Kind of Pkgs. Description of Goods Quantity Invoice No. & Date
Container No.

Certification Declaration by the exporter


It is hereby certified on the basis of control carried out, that the The undersigned hereby declares that the above details and
declaration by the exporter is correct statements are correct; that all the goods were produced in
INDIA

Country
and that they comply with the origin requirements for exports to

(importing country)

Place and date signature and stamp of authorised signatory Place and date signature and stamp of authorised signatory

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