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中国-东盟自贸区优惠关税原产地证（FormE）

onsignedfrom(Exporter’sbusinessname,

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。）

ReferenceNo.

(CombinedDeclarationandCertificate)

FORME

IssuedinThePeople’sRepublicofChina

(Country)

SeeInstructionOverleaf

onsignedto(Consignee’s

name,address,country)

icialuse

PreferentialTreatmentGivenUnderASEAN-CHINA

FreeTreadeAreaPreferentialTariff

PreferentialTreatmentNotGiven(Pleasestatereason/s)

…………………………………………………………

SignatureofAuthorisedsignatoryoftheimportingCountry

………………………………………………………………

SignatureofAuthorisedsignatoryoftheimportingCountry

ftransportandroute(asfarasknown)

DepartureDate走船时间???

Vessel’sname/Aircraftetc.船名船次???

Portofdischarge:目的港口，目的港（目的国）：

（无需填写：进口国海关在该栏注明根据协定是否给予优惠）

item

number

nd

num-

beron

Packages

andtypeof

packages,descriptionfogoods

(includingquantitywhereappropriate

andHSnumberoftheimporting

Country)

criterion

(seenotes

overleaf)

weightor

Other

Quantity

andvalue

(FOB)

anddateof

invoices:发票号码/时

间

1

2

3

ationbytheexporter

Theundersignedherebydeclaresthattheabove

detailsandstatementsarecorrect,thatallthegoods

wereproducedin

……………………………………………………

(Country)

andthattheycomplywiththeoriginrequirements

specifiedforthesegoodsintheAsia–PacificTrade

Agreementforgoodsexportedto(无需填写)

…………………………………………(Importing

Country)

………………………………………………………

………

Placeanddate,signatureofauthorizedSignatory

icate

Itisherebycertifiedonthebasisofcontrolcarriedout,thatthe

declarationbytheexporteriscorrect.

（无需填写）

…………………………………………………

Placeanddate,signatureandStampofCertifyingAuthority