1.Exporter

C O
2.Consignee
TO ORDER

3.Means of transport and route
ON/AFTER JULY. 17, 2010
FROM SHUNDE, CHINA
TO ZEEBRUGGE, BELGIUM BY SEA.

5.For Certifying authority use only
4.Country/region of destination
BELGIUM

6.Marks and numbers

N/A

7.Number and kind of packages; description of goods

TWO HUNDRED AND TWENTY NINE (229) CTNS OF

COFFEE MAKER
8.H.S Code

85.16

9.Quantity

916PCS
10.Number
and date of invoices

CI299-10003 JULY.17,2010

11.Declaration by the exporter

………………………………………………………
Place and date, signature and stamp of authority
12.Certification

……………………………………………………………..
Place and date, signature and stamp of certifying authority

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