今天小编就为大家分享一篇原产地证明书样本，具有很好的参考价值，希望对大家有所帮助。
原产地证书是证明货物的生产或制造地的文件，简称原产地证，原产地证书在国际贸易中往往被进口国用来作为实行区别关税待遇和实施国别贸易政策管理的重要依据，例如最惠国待遇、政府采购、保障措施的正确实施等等，因此具有待定的法律效力和经济作用。下面是亚太贸易协定的原产地证明书，供大家参考。
SAMPLE CERTIFICATE OF ORIGIN
Asia-Pacific Trade Agreement
(Combined declaration and certificate)
1.Goods consigned from:
(Exporter’s businename, address, country)
Reference No.
Issued in …………….
(Country)
2. Goods consigned to:
(Consignee’s name, address, country)
3.For Official use
4. Means of transport and route:
5.Tariff item number:6. Marks and number of Packages: 7. Number
and kind of packages/
description
of goods:
8. Origin
criterion
(see notes
overleaf)9. Gross
weight
or other
quantity:10. Number and date of invoices:
11. Declaration by the exporter :
The undersigned hereby declares that the above details and statements are correct: that all the goods were produced in
……………………………….
(Country)
and that they comply with the origin requirements specified for these goods in the Asia-Pacific Trade Agreement for goods exported to
……………………………….
(Importing Country)
……………………………….
Place and date, signature of authorized
Signatory 12. Certificate
It is hereby certified on the basis of control carried out, that the declaration by the exporter is correct.
…………………………………
Place and date, signature and Stamp of
Certifying Authority
Notes for completing Certificate of Origin
I. General Conditions:
To qualify for preference, products must:
a) fall within a description of products eligible for preference in the list of concessions of an Asia-Pacific Trade Agreement country of destination;
b) comply with Asia-Pacific Trade Agreement rules of origin. Each article in a consignment must qualify separately in its own right; and
c) comply with the consignment conditions specified by the Asia-Pacific Trade Agreement rules of origin. In general, products must be consigned directly within the meaning of Rule 5 hereof from the country of exportation to the country of destination.
II.Entries to be made in the boxes
Box1Goods Consigned from
Type the name, addreand country of the exporter. The name must be the same as the exporter described in the invoice.
Box2Goods Consigned to
Type the name, addreand country of the importer. The name must be the same as the importer described in the invoice. For third party trade, the words “To Order” may be typed.
Box3For Official Use
Reserved for use by certifying authority.
Box4Means of Transport and Route
State in detail the means of transport and route for the products exported. If the L/C terms etc. do not require such details, type “By Air” or “By Sea”. If the products are transported through a third country this can be indicated as follows: e.g. “By Air” “Laos to India via Bangkok”
Box5Tariff Item Number
Type the 4-digit HS heading of the individual items.
Box6Marks and Numbers of Packages
Type the marks and numbers of the packages covered by the Certificate. This information should be identical to the marks and numbers on the packages.
Box 7 Number and Kind of Packages; Description of Goods
Type clearly the description of the products exported. This should be identical to the description of the products contained in the invoice. An accurate description will help the Customs Authority of the country of destination to clear the products quickly.
Box8Origin Criterion
Preference products must be wholly produced or obtained in the exporting Participating State in accordance with Rule 2 of the Asia-Pacific Trade Agreement Rules of Origin, or where not wholly produced or obtained in the exporting Participating State must be eligible under Rule 3 or Rule 4.
a) Products wholly produced or obtained: enter the letter “A” in Box 8.
b) Products not wholly produced or obtained: the entry in Box 8 should be as follows:
1.Enter letter “B” in Box 8, for products which meet the origin criteria according to Rule 3. Entry of letter “B” would be followed by the sum of the value of materials, parts or produce originating from non-Participating States, or undetermined origin used, expressed as a percentage of the f.o.b. value of the products; (example “B” 50 per cent);
2.Enter letter “C” in Box 8 for products which meet the origin criteria according to Rule 4. Entry of letter “C” would be followed by the sum of the aggregate content originating in the territory of the exporting Participating State expressed as a percentage of the f.o.b. value of the exported product; (example “C” 60 per cent);
3.Enter letter “D” in Box 8 for products which meet the special origin criteria according to Rule 10.
Box 9 GroWeight or Other Quantity
Type the groweight or other quantity (such as pieces, kg) of the products covered by the Certificate.
Box 10 Number and Date of Invoices
State number and date of the invoice in question. The date of the invoice attached to the Application should not be later than the date of approval on the Certificate.
Box 11 Declaration by the Exporter
The term “Exporter” refers to the shipper who can either be a trader or a manufacturer. Type the name of the producing country and the importing country and the place and date when the declaration is made. This box must be signed by the Company’s authorized signatory.
Box 12 Certification
The certifying authority will certify in this Box.
原产地证书样本 亚太贸易协定（中文文本仅供参考）
(申报和证书合一)
1.货物运自(出口人名称、地址、国家)：
编号：
……………. …. …. …. ….签发
(国家)
2. 货物运至(收货人名称、地址、国家)：3. 官方使用
4.运输工具及路线
5.税则号列6. 包装唛头及编号 7. 包装件数及种类;货物名称8. 原产地标准(见背页说明)9. 毛重或者其他数量10.发票编号及日期
11.出口人声明
下列签字人证明上述资料及申明正确无讹，所有货物产自
……………………………….
(国家)
且符合亚太贸易协定原产地规则的相关规定，该货物出口至
……………………………….
(进口国)
…………………………….
申报地点、日期及授权签字人的签字 12. 证明
根据所实施的监管，兹证明上述出口商的申报正确
…………………………………
地点和日期，签字和签证机构印章
背页填制说明
一、总原则：
享受关税减让优惠的货物必须符合以下条件：
1. 属于《亚太贸易协定》进口成员国关税减让优惠产品清单的范围。
2. 符合《亚太贸易协定》原产地规则。同批货物中的每项商品均要符合该规则。
3. 符合《亚太贸易协定》原产地规则中的直接运输条款规定。一般情况下，货物必须按照第五条的规定从出口国直接运输到进口国

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二、表格各栏应填写的内容：
第1栏：货物出口人。注明出口人的全称、地址和国家。须与发票上的出口人名称一致。
第2栏：货物收货人。注明收货人的全称、地址和国家。该收货人名称必须与发票上的进口商名称一致。如果属于第三方贸易，应该注明“凭背书”字样

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第3栏：官方使用。由签发证书机构填写。
第4栏：运输工具和线路。详细注明出口货物的运输工具和路线。如果信用证等单证未详细列明时，应注明“空运”或“海运”字样;如果货物运输途中经过第三国时，应当按照下列方式注明：
例如：“空运” “从老挝至印度途经曼谷”
第5栏：税则号列。注明各项商品的4位HS编码。
第6栏：包装唛头及编号。注明包装上的唛头及编号。应当与货物包装上的唛头及编号相一致。
第7栏：包装件数及种类；货物名称。注明出口货物名称。应当与发票上的名称相符。准确的货物名称有助于进口国海关快速清关。
第8栏：原产地标准。享受关税减让优惠的货物必须符合《亚太贸易协定》原产地规则第二条规定，是在出口成员国完全获得或者生产的;或者在出口成员国非完全获得或者生产的符合原产地规则第三条、第四条规定的。
1. 完全获得或者生产的：在第8栏中填写字母“A”
2. 非完全获得或者生产的：在第8栏中应当按照下列方式填写：
(1)如果符合第三条规定的原产地标准，则在第8栏中填写字母“B”。在字母“B”的后面填上使用非成员国原产或不明原产地的材料、零件或产物的总价值，以在船上交货价格(FOB价格)中所占的百分比表示，(如“B”50%);
(2)如果符合第四条规定的原产地标准，则在第8栏中填写字母“C”。在字母“C”的后面填上在出口成员国原产成分的累计总和，以占出口货物的成本加运费、保险费价格(CIF价格)的百分比表示，(如“C”60%);
(3)如果符合原产地规则第十条规定的特殊比例标准，则第8栏中填写字母“D”;
第9栏：毛重或者其他数量。注明货物毛重或其他数量(如件数、公斤)

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第10栏：发票编号及日期。注明发票编号及日期。随附发票上的日期不应当迟于原产地证书格式正式启用的日期。
第11栏：出口人声明。“出口人”是指发货人，该发货人可以是贸易商也可以是制造商

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。声明中应当注明原产国、进口国、地址和日期。且该栏目应当由公司授权人员签名

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第12栏：证明。本栏目由签证机构签章确认

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