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1、1.Goods consigned fromfExportefs Jxisiness name, address, country)不能超过四行 . . . .Reference No. / 二二一-.- -士 . . , , :泞、三二二二二里GENERALIZED SYSTEM OF PREFERENCES - 一. . - -二.：/ CERTIFICATE OF ORIGIN2.Goods consigned to(Consignee* name, address, country)(Combined declaration and certificate)FORMA*_* - - J
2、 .-二-、Issued in THE PEOPLES REPUBLIC OF CHINA_ -(country)See Notes overleaf4.For Official use3.Means of transport and route (as far as known) ON/AFTER JULY. 17, 2010FROM SHUNDE, CHINATO ALGIERS, ALGERIA BY SEA.5.Item6.Marks and numbers ofnumber packagesN/A7.Number and kind of packages; description g
3、oodsTWO HUNDRED AND TWENTY NINE (229) CTNS OF COFFEE MAKER8.origin criterion (see Notes overleaf)9.Gross weight or other quantity10.Number and date of invoices“p，5293.PCSJULY. 17,202211 .CertificationIt is hereby certified, on the basis of control carried out, that the declaration by the exporter is
4、 correct.12 .Declaration by the exporterThe undersigned hereby declares that the above details and statements are correct; that all the goods were produced inCHINA(country)and that they comply with the origin requirements specified for those goods in the Generalized System of Preferences for goods exported toALGERIA(importing country)Place and date, signature and stamp of certifying authorityPlace and date, signature of authorized signatory