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1、ATTACHMENT COriginal (Duplicate/Triplicate)Reference No.1. Products consigned from (Exporters business name, address, country)ASEAN-CHINA FREE TRADE AREAPREFERENTIAL TARIFFCERTIFICATE OF ORIGIN(Combined Declaration and Certificate)2. Products consigned to (Consignees name, address, country)FORM EIss

2、ued in(Country)See Overleaf Notes3. Means of transport and route (as far as known)Departure dateVessels name/Aircraft etc.Port of Discharge5. Item number6. Marks and numbers on packages7. Number and type of packages, description of products (including quantity where appropriate and HS number of the

3、importing Party)4. For Official UseoPreferential Treatment GivenPreferential Treatment Not Given (Please state reason/s)Signature of Authorised Signatory of the Importing Party8. Origin criteria (see Overleaf Notes)9. Gross weight or other quantity and value(FOB)10. Number and date of invoices11. De

4、claration by the exporterThe undersigned hereby declares that the above details and statement are correct; that all the products were produced in(Country)and that they comply with the origin requirements specified for these products in the Rules of Origin for the ACFTA for the products exported to(I

5、mporting Country)Place and date, signature ofauthorised signatory12. CertificationIt is hereby certified, on the basis of control carried out, that the declaration by the exporter is correct.Place and date, signature and stamp ofcertifying authority13 Issued Retroactively Movement Certificate Exhibi

6、tion Third Party InvoicingOVERLEAF NOTES1. Parties which accept this form for the purpose of preferential treatment under the ASEAN-CHINA Free Trade Area PreferentialTariff:BRUNEI DARUSSALAMCAMBODIACHINAINDONESIALAOSMALAYSIAMYANMARPHILIPPINESSINGAPORETHAILANDVIETNAM2. CONDITIONS: The main conditions

7、 for admission to the preferential treatment under the ACFTA Preferential Tariff are that products sent to any Parties listed above:(i) must fall within a description of products eligible for concessions in the country of destination;(ii) must comply with the consignment conditions that the products

8、 must be consigned directly from any ACFTA Party to the importing Party but transport that involves passing through one or more intermediate non-ACFTA Parties, is also accepted provided that any intermediate transit, transshipment or temporary storage arises only for geographic reasons or transporta

9、tion requirements; and(iii) must comply with the origin criteria given in the next paragraph.3. ORIGIN CRITERIA: For exports to the above mentioned countries to be eligible for preferential treatment, the requirement is that either:(i) The products wholly obtained in the exporting Party as defined i

10、n Rule 3 of the Rules of Origin for the ACFTA;(ii) Subject to sub-paragraph (i) above, for the purpose of implementing the provisions of Rule 2 (b) of the Rules of Origin for the ACFTA, products worked on and processed as a result of which the total value of the materials, parts or produce originati

11、ng from non-ACFTA Parties or of undetermined origin used does not exceed 60% of the FOB value of the product produced or obtained and the final process of the manufacture is performed within territory of the exporting Party;(iii) Products which comply with origin requirements provided for in Rule 2

12、of the Rules of Origin for the ACFTA and which are used in a Party as inputs for a finished product eligible for preferential treatment in another Party/Parties shall be considered as a product originating in the Party where working or processing of the finished product has taken place provided that

13、 the aggregate ACFTA content of the final product is not less than 40%; or(iv) Products which satisfy the Product Specific Rules provided for in Attachment B of the Rules of Origin for the ACFTA shall be considered as products to which sufficient transformation has been carried out in a Party.If the

14、 products qualify under the above criteria, the exporter must indicate in Box 8 of this form the origin criteria on the basis of which he claims that his products qualify for preferential treatment, in the manner shown in the following table:Circumstances of production or manufacture in the first co

15、untry named in Box 11 of this formInsert in Box 8(a) Products wholly produced in the country of exportation (see paragraph 3 (i) above)“WO”(b) Products worked upon but not wholly produced in the exporting Party which were produced in conformity with the provisions of paragraph 3 (ii) abovePercentage

16、 of single country content, example 40%(c) Products worked upon but not wholly produced in the exporting Party which were produced in conformity with the provisions of paragraph 3 (iii) abovePercentage of ACFTA cumulative content, example 40%(d) Products satisfied the Product Specific Rules (PSR)“PS

17、R”4. EACH ARTICLE MUST QUALIFY: It should be noted that all the products in a consignment must qualify separately in their own right. This is of particular relevance when similar articles of different sizes or spare parts are sent.5. DESCRIPTION OF PRODUCTS: The description of products must be suffi

18、ciently detailed to enable the products to be identified by the Customs Officers examining them. Name of manufacturer, any trade mark shall also be specified.6. The Harmonised System number shall be that of the importing Party.7. The term “Exporter” in Box 11 may include the manufacturer or the prod

19、ucer. In the case of MC the term “Exporter” also includ es the exporter in the intermediate Party,8. FOR OFFICIAL USE: The Customs Authority of the importing Party must indicate （ ） in the relevant boxes in column 4 whether or not preferential treatment is accorded9. Movement Certificate: In cases o

20、f Movement Certificate, in accordance with Rule 12 of the Operational Certification Procedures, “Movement Certificate” in Box 13 should be ticked （寸）.The name of original Issuing Authorities of the Party, date of the issuance and the reference number of the original Certificate of Origin （Form E） to

21、 be indicated in Box 13.10. THIRD PARTY INVOICING: In cases where invoices are issued by a third country, “the Third Party Invoicing” in Box 13 shall be ticked （寸）.The invoice number shall be indicated in Box 10. Information such as name and country of the company issuing the invoice shall be indica

22、ted in Box 7.11. EXHIBITIONS: In cases where products are sent from the exporting Party for exhibition in another Party and sold during or after the exhibition for importation into a Party, in accordance with Rule 22 of Attachment A of the Rules of Origin for the ACFTA, the “Exhibitions” in Box 13 s

23、hould be ticked （寸）and the name and address of the exhibition indicated in Box 2.12. ISSUED RETROACTIVELY: In exceptional cases, due to involuntary errors or omissions or other valid causes, the Certificate of Origin （Form E） may be issued retroactively in accordance with Rule 11 of Attachment A of

24、the Rules of Origin for the ACFTA. The “Issued Retroactively” in Box 13 shall be ticked （寸）.正本（第二副本/第三副本）1.产品运自（出口商名称、地址、国家）：编号：中国-东盟自由贸易区 优惠关税 原产地证书（申报与证书合一） 表格E签发 （国家）见背页说明2.产品运至（收货商名称、地址、国 家）：3运输工具及路线（已知）：离港日期：船舶名称/飞机等：卸货口岸：4.官方使用口给予优惠待遇；口不给予优惠待遇（请注明原因）进口成员方有权签字人签字5项 目编 号6.包装 唛头及 编号7包装件数及种类；产品 名称

25、（包括相应数量及 进口成员方HS编码）8.原产地标 准（见背页 说明）9.毛重或其他 数量及价格（FOB）10.发票编号 及日期11.出口商声明下列签字人声明上述资料及申报正确无 讹，所有产品产自（国家）且符合中国一东盟自由贸易区原产地规则所规定的原产地要求,该产品出口至（进口国）地点和日期，有权签字人的签字12.证明根据所实施的监管，兹证明出口商所做申报正 确无讹。地点和日期，签字和发证机构印章13.口补发口展览口流动证明口第三方发票背页说明1 为享受中国-东盟自由贸易区优惠关税协议下优惠待遇而接受本证书的 缔约各方：文莱、柬埔寨、中国、印度尼西亚、老挝、马来西亚、缅甸、菲律 宾、新加坡、泰

26、国、越南2 条件：出口至上述任一方的产品，享受中国-东盟自由贸易区优惠关税 协议下优惠待遇的主要条件是：必须是在目的国可享受关税减让的产品；必须符合产品由中国东盟自由贸易区任一方直接运至进口方的运输条件， 但如果过境运输、转换运输工具或临时储存仅是由于地理原因或仅出于运输需 要的考虑，运输途中经过一个或多个中国-东盟自由贸易区非缔约方境内的运输 亦可接受；以及必须符合下述的原产地标准。3原产地标准：出口到上述国家可享受优惠待遇的货物必须符合下列要求 之一:符合中国-东盟自由贸易区原产地规则三的规定，在出口成员方完全获得的 立口 .产口口；除上述第（1 ）项的规定外，为实施中国-东盟自由贸易区原

27、产地规则二 （二）的规定，使用原产于中国-东盟自由贸易区非缔约方或无法确定原产地的 材料、零件或产物生产和加工产品时，所用材料、零件或产物的总值不超过生 产或获得产品船上交货价格的60%，且最后生产工序在出口方境内完成；符合中国-东盟自由贸易区原产地规则二规定的原产地要求的产品，且该产 品在一方用作生产在其他一个或多个缔约方可享受优惠待遇的最终产品的投入 品，如最终产品中中国-东盟自由贸易区成分总计不少于最终产品的40%，则该 产品应视为原产于对最终产品进行生产或加工的一方；或符合中国-东盟自由贸易区原产地规则附件的产品特定原产地标准的产品 应视为在一方进行了充分加工的货物。若产品符合上述标准

28、，出口商必须按照下列表格中规定的格式，在本证书 第八栏中标明其产品申报享受优惠待遇所依据的原产地标准：本表格第11栏列名的第一国生产或制造的详情填入第8栏（a）出口国完全生产的产品（见上述第3款（1 ） 项）“完全获得”（b）符合上述第3款（2）项的规定，在出口方加工 但并非完全获得的产品单一国家成分的百分比，例 如40%（c）符合上述第3款（3 ）项的规定，在出口方 加工但并非完全获得的产品中国-东盟累计成分的百分 比，例如40%（d）付合产品特定原产地标准（PSR ）的产品“PSR”4每一项商品都必须符合规定：应注意一批货物中的所有产品都必须各自 符合规定，尤其是不同规格的类似商品或备件。

29、5 产品名称：产品名称必须详细，以使验货的海关官员可以识别。生产商 的名称及任何商标也应列明。6协调制度编码应为进口方的编码。7第 11 栏“出口商”可包括制造商或生产商。作为流动证明时，“出口商” 也包括中间方的出口商。8 官方使用：不论是否给予优惠待遇，进口方海关必须在第4栏作出相应 的标注3 ）。9. 流动证明：作为流动证明时，按照签证操作程序规则十二条的规定，第 13栏中的“流动证明”应予以标注（7）。成员方的原始签证机构名称、签发日 期以及原始原产地证书（Form E ）证书的编号也应在第13栏中注明。10. 第三方发票：当发票是由第三国开具时，第13栏中的“第三方发票”应予 以标注（7 ）。该发票号码应在第10栏中注明。开具发票的公司名称及所在国 家等信息应在第7栏中注明。11. 展览：当产品由出口方运至另一方展览并在展览期间或展览后销售给一 方时，按照中国-东盟自由贸易区原产地规则22的规定，第13栏中的“展览”应 予以标注（7 ）。展览的名称及地址应在第2栏中注明。12. 补发：在特殊情况下，由于非主观故意的差错、疏忽或者其他合理原因，可按照中国-东盟自由贸易区原产地规则十一的规定补发原产地证书（Form E ）。第13栏中的“补发”应予以标注（7 ）。