原产地证书CO样本
原产地证书格式
ORIGINAL
14．Declaration by the exporter
The undersigned hereby declares that the above details and statement are correct, that all the goods were produced in
（Country）
and that they comply with the origin requirements specified in the FTA for the goods exported to
（Importing country）
Place and date, signature of authorized signatory
15．Certification
It is hereby certified, on the basis of control carried out, that the declaration of the exporter is correct.
Place and date
Certifying authority Tel: Fax: Address:
Overleaf Instruction
Box 1: State the full legal name, address (including country) of the exporter.
Box 2: State the full legal name, address (including country) of the producer. If more than one producer’s good is included in the certificate, list the additional producers, including name, address (including country). If the exporter or the producer wishes the information to be confidential, it is acceptable to state “Available to the competent governmental authority upon request”. If the producer and the exporter are the same, please complete field with “SAME”. If the producer is unknown, it is acceptable to state
Box 4: Complete the means of transport and route and specify the departure date, transport vehicle No., port of loading and discharge. Box 5: The customs authorities of the importing country must indicate (√ ) in the relevant boxes whether or not preferential tariff treatment is accorded.
Box 6: Customer’s Order Number, Letter of Credit Number, and etc. may be included if required. If the invoice is issued by a non-Party operator, the name, address of the producer in the originating Party shall be stated herein. Box 7: State the item number, and item number should not exceed 20. Box 8: State the shipping marks and numbers on the packages.
Box 9: Number and kind of package shall be specified. Provide a full description of each good. The description should be sufficiently detailed to enable the products to be identified by the Customs Officers examining them and relate it to the invoice description and to the HS description of the good.
If goods are not packed, state “in bulk”. When the description of the goods is finished, add “***” (three stars) or “ \ ” (finishing slash). Box 10: For each good described in Box 9, identify the HS tariff classification to six digits.
Box 11: If the goods qualify under the Rules of Origin, the exporter must indicate in Box 11 of this form the origin criteria on the basis of which he claims that his goods qualify for preferential tariff treatment, in the manner shown in the following table:
Box 12: Gross weight in Kilos should be shown here. Other units of measurement e.g. volume or number of items which would indicate exact quantities may be used when customary.
Box 13: Invoice number, date of invoices and invoiced value should be shown here.
Box 14: The field must be completed, signed and dated by the exporter. Insert the place, date of signature.
Box 15: The field must be completed, signed, dated and stamped by the authorized person of the certifying authority. The telephone number, fax and address of the certifying authority shall be given.
原产地证书格式（中文译文仅供参考）
第一栏：应填写出口商详细的依法登记的名称、地址（包括国家）。
第二栏：在已知的情况下填写生产商详细的依法登记的名称、地址（包括国家）。如果证书包含一个以上生产商的商品，应该列出其
他生产商的详细名称、地址（包括国家）。如果出口商或生产商希望对信息予以保密，可以填写“应要求提供给签证机构（Available to competent governmental authority upon request）”。如果生产商和出口商相同，应填写“相同（SAME）”。如果不知道生产商，可填写“不知道（UNKNOWN）”。
第三栏：应填写收货人详细的依法登记的名称、地址（包括国家）。
第四栏：应据所知填写运输方式及路线、详细说明离港日期、运输交通工具的编号、装货口岸和到货口岸。
第五栏：不论是否给予优惠待遇，进口方海关必须在相应栏目标注(√ )。
第六栏：如有要求可以填写顾客顺序号、信用证号等。如果发票是由非缔约方开出的，应在此栏标注原产国生产商的名称、地址和国
家。
第七栏：应填写项目号，但不得超过20项。 第八栏：应填写唛头及包装号。
第九栏：应详细列明包装数量及种类。对每种货物提供详细的货物描述，以便于查验的海关关员可以识别。货物描述应与发票描述及
货物的协调制度编码相符。如果是散装货，应注明“散装”。当货物描述结束时，加上“***”（三颗星）或“＼”（结束斜线符号）。
第十栏：应对应第九栏中的每种货物填写协调制度编码，以六位编码为准。
第十一栏：若货物符合原产地规则，出口商必须按照下列表格中规定的格式，在本证书第十一栏中标明其货物申报享受优惠待遇所根
第十三栏：应填写发票号、发票日期及发票价。
第十四栏：本栏必须由出口商填写、签名并填写日期。且应该填写签名的地点及日期。
第十五栏：本栏必须由签证机构的授权人员填制、签名、填写签证日期并盖章。并应提供签证机构的电话号码，传真及地址。
under China-Chile Free Trade Agreement shall be valid for one year from the date of issue in the exporting country.
[1]
中国-智利自贸区协定项下的原产地证书应在自出口方签发之日起一年内有效。
原产地证明书申请书
申请单位及注册号码（盖章）： 证书号：
申请人郑重声明：
本人是被正式授权代表单位申请办理原产地证明书和签署本申请书的。
本人所提供原产地证明书及所付单据内容正确无误，如发现弄虚作假，冒充证书所列货物，擅改证书，自愿接受签证机关的处罚及负法律责任。现将有关情况申报如下：
现提交出口商业发票副本一份，原产地证书一套，以及其他附件 份，请予审核签证。
*注：“产品进口成分”栏是指产品含进口成分的情况，如果该产品不含进口成份，则填0%，若含进口成份，则此栏填进口成分占产品出厂价的百分比。