2024年3月8日发(作者：pscs5下载)

中国-东盟自贸区优惠关税原产地证（Form E）

1. Goods consigned from (Exporter’s business name,

Reference No.

(Combined Declaration and Certificate)

address, country)

（填写出口人合法的全称、地址和国名。

该出口人必须是在商检局登记的公司。）

FORM E

Issued in The People’s Republic of China

(Country)

See Instruction Overleaf

2. Goods consigned

name,address,country)

to(Consignee’s official use

Preferential Treatment Given Under ASEAN-CHINA

Free Treade Area Preferential Tariff

Preferential Treatment Not Given(Please state reason/s)

…………………………………………………………

Signature of Authorised signatory of the importing Country

………………………………………………………………

3. Means of transport and route(as far as known)

Departure Date 走船时间???

Vessel’s name/Aircraft etc.船名船次???

Port of discharge: 目的港口，目的港（目的国）：

item

number

1

2

3

Signature of Authorised signatory of the importing Country

（无需填写：进口国海关在该栏注明根据协定是否给予优惠）

6. Marks and

num-

ber on

Packages

and type of

packages,description fo goods

(including quantity where appropriate

and HS number of the importing

Country)

criterion

(see notes

overleaf)

weight or

Other

Quantity

and value

(FOB)

and date of

invoices:发票号码/时间

ation by the exporter

The undersigned hereby declares that the above

details and statements are correct, that all the goods

were produced in

……………………………………………………icate

It is hereby certified on the basis of control carried out, that the

declaration by the exporter is correct.

(Country)

and that they comply with the origin requirements

（无需填写）

specified for these goods in the Asia–Pacific Trade

…………………………………………………

Agreement for goods exported to (无需填写)

Place and date, signature and Stamp of Certifying Authority

…………………………………………(Importing

Country)

………………………………………………………………

Place and date, signature of authorized Signatory