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    • 001
    • 000
    China-Peru Certificate of Origin FORM R
     
    1.  Exporter’s name, address, country:
    SHENZHEN GREAT FORTUNE IMPORT & EXPORT CO., LTD
    ROOM 203, FLOOR 2, BUILDING 2, CHENGXI INDUSTRIAL
    PARK HEXI, XIXIANG, BAOAN, SHENZHEN, CHINA
    2. Producer's name and address, if known:
    3.  Consignee’s name

     
    Certificate No.:   

     
    CERTIFICATE OF ORIGIN
    Form for China-Peru FTA
    Issued in the People's Republic of China   
    (see Overleaf Instruction)


     
    4. Means of transport and route (as far as known):
    Departure Date:
    Vessel/Flight/Train/Vehicle No.:
    Port of loading:
    Port of discharge:
     
    For Official Use Only:
     



     
    5, Remarks:
     



     
    6.ltem
    number
    (Max 20)
     





     
    7. Number and kind of packages;
    description of goods               
     


     
    8. HS code
    (6 digit code)
     





     
    9. Origin
    criterion
     





     
    10. Gross weight
    or other quantity
    (e.g.Quantity
    Unit liters, m3.)
     



     
    11.Number and date
    of invoice

     




     
    13.  Declaration by the exporter:
    The undersigned bereby declares that the above stated
    information is correct, and that all the goods are produced in

    and that they comply with the origin requirements specified in
    the Free Trade Agreement for the goods exported to

     (Importing country)
    Place, date and signature of authorized person
    14. Certification:
    On the basis of the carried out control, it is hereby certified that the information
    herein is correct
    Place and date , signature and stamp of the Authorized Body


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