`
CERTIFICATE OF ORIGIN
1. Product consigned from
Issued in Germany
Herzogenaurach - Limited Liability
Sea Overleaf Notes
Company Address: Berlin – Germany
2. Product consigned to
Nghia Bi Company
Address: 68 Me Linh Street, Hong Bang District, Hai Phong city
3. Mean of transport and route (as far as known) 4. For Official Use
Ship
☑ Preferential Treatment
Given
Departure date
10 October 2022 Preferential
◻ Treatment Not Given
(Please state reason/s)
Vessel’s Name
IMGERVIE K59
………
Port of Discharge
Tan Vu port, Hai Phong City, Vietnam Signature of authorized Signatory of the Importing
party
5. Item 6. Marks 7. Number and type of 8. 9. Gross Weight or 10. Number and date of
Number and packages, description of Origin other quantity and invoice
numbers products (including criteria value (CIF)
on quantity where appropriate (sea
packages and HS number of the overleaf
importing Party) notes)
10.000 shoes brand Adidas
Stansmith G.W 5000 KG 73/INV-SINT
01 N/M “WO”
USD: 500,000 09 October 2022
HS code: 6404.11.90
11. Declaration by the exporter 12. Certification
It is hereby certified, on the basis of control carried out, that the
The Undersigned hereby declares that the above detail declaration by the exporter is correct.
and statement are correct; and that all products were
produced in GERMANY
and that they comply with the origin requirement
specified for these products in the Rules of Origin so the
ACFTA for the products exported to VIET NAM
BERLIN, GERMANY, 09 October 2022
13
◻ Issued ◻ Exhibition
Retroactively
◻ Movement ◻ Third Party GERMANY, 9 October 2022
Certificate Invoicing
