Certificate No.: R19470ZC41091001
CERTIFICATE OF ORIGIN
Form for China-Peru FTA
Issued in
the People's Republic of China
(see Overleaf Instruction)
For Official Use Onley:
Verification:origin.customs.gov.cn
1.Exporter's name and address: 出口商名称及地址:
SHENZHEN WANLIYUAN IMP&EXP CO.,LTD
3B16 THREEFLOOR JINGZE BUILDING SHENNAN ROAD
EAST YELLOW BAY STREET LUOHU DISTRICT
SHENZEHN,CHINA
2.Producer's name and address, if known: 生产商名称及地址(如已知):
此栏可以显示生产商信息，如果生产商信息不想显示，可以显示如下保密方式：
AVAILABLE TO THE COMPETENT AUTHORITY OR AUTHORISED BODY UPON REQUEST
3.Consignee's name and address: 收货人名称和地址:
NESTOR ****** APAZA
ADDRESS: ******** (PABELLON T PUESTO 2 BASE 3)
PUNO - SAN ROMAN - JULIACA,PERU
4.Means of transport and route (as far as known): 运输工具和路线(据所知):
Departure Date 发货日期: JUL.26,2019
Vessel/Flight/Train/Vehicle No. : 船/飞机/火车/汽车号.：3U8782
Port of loading : 装货港: SHENZHEN,CHINA
Port of discharge :卸货港: CALLAO,PERU
5.Remarks: 备注：
此栏允许显示第3方公司信息，如：
NON-PARTY OPERATOR:
AL* ******** COMPANY LTD
******** BLDG 3 HAU FOOK ST TSIM SHA TSUI KL
6.Item number (Max 20) 项目编号（最大20项）
1.
2.
3.
........ 20. 最多20项品名编号
7.Number and kind of packages; description of goods 包装的数量和种类;货物的描述
LED MODULE
TOTAL: THIRTEEN (13) CARTONS ONLY.
8.HS code (Six digit code) HS码(六位数码)
9405.40
9.Origin criterion 原产地标准
WP 属于完全原产代码
10.Gross weight, quantity( Quantity Unit) or other measures( liters, m3, etc.)
毛重、数量(数量单位)或其他措施(升、立方米等)
1300PCS
11.Number and date of invoices 发票号码及日期
JS-2650
JUL. 15,2019
12.Invoiced value 发票价值
FOB:USD
3900.00
13.Declaration by the exporter: 出口商声明:
The undersigned hereby declares that the above details and
statement are correct,that all the goods were produced in
CHINA
.........................................................................................................
(Country)
and that they comply with the origin requirements specified in the FTA
for the goods exported to
PERU
...............................................................................................
(Importing country)
SHENZHEN,CHINA,
...............................................................................................
Place and date,signature of authorized signatory
14.Certification: 官方认证：
On the basis of control carried out, it is hereby certified that the
information herein is correct and that the goods described comply with
the origin requirements specified in the China-Peru FTA.
..........................................................................................................
Place and date,signature and stamp of authorized body
