一般原產地證明書/加工裝配申請書
Application for General Certificate of Origin / Processing & Assembling
申請單位注冊號：證書號：
Registry No. of the Certificate No.
Applying Corporation
申請人鄭重聲明：
本人被正式授權代表本企業辦理和簽署本申請書。
本申請書及一般原產地證明書/加工裝配證明書所列內容正確無誤，如發現弄虛作假，冒充證書所列貨物，擅改證書，本人愿按《中華人民共和國出口貨物產地規則》的有關規定接收處罰�，F將有關情況申報如下：
I, the undersigned Applicant, hereby declare that I am the representative formally authorized by the said corporation to deal with and sign this Application and I agree that the statement herein and that in the General Certificate of Origin or the Certificate of Processing & Assembling are correct and of no mistake and I shall be sanctioned in accordance with the Regulations of the Origin for Exports of the People's Republic of China if any fraud, passing off any goods as those listed in the certificate or any unauthorized modification of the certificate exists. The items reported as follows:
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企業名稱
Name of Corp. |
發票號
Invoice No. |
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商品名稱
Prescription |
H.S.編碼（六位數）
No. of H.S. |
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商品FOB總值（以美元計）
Value（FOB）US ¥ |
最終目的地國/地區
Destination Country（District） |
續表
|
擬出運日期
Shipping Date |
轉中國（地區）
Transshipment Country（district） |
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貿易方式和企業性質（請在適用處劃“√”）
Mode of Business & Nature of Corp.
(Please follow the instructions with “√”) |
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一般貿易
Ordinary Business |
三來一補
* 3 Processings & 1 Trade |
其他貿易方式
Others |
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國營企業 三資企業
1.State-owned
enterprise
2.Sino-foreign
joint venture；
Sino-foreign
Co-op；
Wholly foreign-owned |
國營企業 三資企業
1.State-owned
enterprise
2.Sino-foreign
joint venture；
Sino-foreign
Co-op；
Wholly foreign-owned |
國營企業 三資企業
1.State-owned
enterprise
2.Sino-foreign
joint venture；
Sino-foreign
Co-op；
Wholly foreign-owned |
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包裝數量或毛重或其他數量
Package Number，or gross weight or other quantity |
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證書種類（劃“√”）
Classification of Certificate (Please follow the instruction with“√” |
一般原產地證明書
General Certificate of Origin |
加工裝配證明書
Processing & Assembling Certificate |
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( * Component parts processing, component assembling, processing with customer's desings; compensation trade)
現提交中國出口貨物商業發票副本一份，一般原產地證明書/加工裝配證明書一正三副，以及其他副件_____份，請予審核簽證。
Enclosed with one copy of the business invoice of Chinese exports, one original General Certificate of Origin/Processing & Assembling and three copies thereof, and other appendices , please have have a check before the certificate is issued.
申請單位蓋章 申領人：（簽名）
（for Seal） Signature of Applicant：
電話：
Tel：
日 期： 年 月 日
Date_________，20__________
