1.Goods consigned from (Exporter's business
name, address, country)不能超过四行

FORM A
2.Goods consigned to(Consignee' name, address, country)

3.Means of transport and route (as far as known)
ON/AFTER JULY. 17, 2010
FROM SHUNDE, CHINA
TO ALGIERS, ALGERIA BY SEA.

4.For Official use
5.Item
number

1

6.Marks and numbers of packages

N/A

7.Number and kind of packages; description goods

TWO HUNDRED AND TWENTY NINE (229) CTNS OF
COFFEE MAKER
8.origin criterion
(see Notes overleaf)

“P”

9.Gross weight or other quantity

5293.PCS

10.Number and date of invoices

CI299-10003 JULY.17,2010

11.Certification
It is hereby certified, on the basis of control carried out, that the declaration by the exporter is correct.

………………………………………………………
Place and date, signature and stamp of certifying authority
12.Declaration by the exporter
The undersigned hereby declares that the above details and statements are correct; that all the goods were produced in

CHINA
……………………………………………………………
(country)
and that they comply with the origin requirements specified for those goods in the Generalized System of Preferences for goods exported to

ALGERIA
…………………………………………………………….
(importing country)

……………………………………………………………..
Place and date, signature of authorized signatory

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作者 灰武士