1. Products consigned from (Exporter’s business name, address, Reference No.
E24545648085330245
country)
NINGBO KELI INTERNATIONAL TRADING CO., LTD ASEAN-CHINA FREE TRADE AREA
NO.199 CHANGXING ROAD,C DISTRICT JIANGBEI PREFERENTIAL TARIFF
INVESTMENT INDUSTRIAL PARK, NINGBO, CHINA
CERTIFICATE OF ORIGIN
(Combined Declaration and Certificate)
2. Products consigned to (Consignee’s name, address, country)
FORM E
LONG VU MARINE TECHNICAL SERVICES
& TRADING COMPANY LIMITED
NO. 12/27 BAC SON STREET Issued in THE PEOPLE’S REPUBLIC OF CHINA
79000 VUNG TAU CITY (Country)
VIETNAM
See Overleaf Notes
3. Means of transport and route (as far as known) 4. For Official Use Verification:origin.customs.gov.cn
Departure Date FEB 26 2024 Preferential Treatment Given
Vessel’s name / Aircraft etc. PH 8090
Preferential Treatment Not Given (Please state reason/s)
Port of Discharge HO CHI MINH, VIETNAM
FROM CHINA TO VUNG TAU, VIETNAM BY FEDEX
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5. Item 6. Marks and 7. Number and type of packages, description 8. Origin criteria 9. Gross weight or net 10. Number
Number numbers on of products (including quantity where (see Overleaf weight or other date of
packages appropriate and HS number in six digit code) Notes) quantity, value (FOB) Invoices
only when RVC
criterion is applied
N/M TOTAL: IN ONE (1) PACKET ONLY 13KGS G.W. J240105
JAN. 04,2024
lOAD CELL NB-T2a 20t 1PIECES
LOAD CELL XZB-T2a 20t 1PIECES
11. Declaration by the exporter 12. Certification
The undersigned hereby declares that the above details and It is hereby certified, on the basic of control carried out, that the
statement are correct; that all the products were produced in declaration by the exporter is correct.
- - - - - - - - - - - - - - - - - - CHINA
---------------------------
(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
- - - - - - - - - - - - - - - - - -VIET
- - - - -NAM
----------------------
(Importing Country)
- - - - - - - - - - - -China,
- - - - - - FEB.
- - - - -29,2024
----------------------
Place and date, signature of authorised signatory
13.
Issued Retroactively Exhibition - - - - - - - - - - - - -China,
- - - - - - -FEB.
- - - - -29,2024
--------------------
Movement Certificate Third Party Invoicing Place and date, signature and stamp of certifying authority
2230296452
