Form Ai: Preferential Tariff Certificate of Origin

 

0. Cllhs ilesa ilesaceoh ceoh grlm ( Oxplrtor' Oxplrtor's jusaeoss e`m e`mo, o, `hhross, iluetry)

Zogoroeio El.

IW. M@ZLW AEXOZE@XALE@K N@K@E X@EN_EC SAZ@ W/9:, ZX.2?, ZS.0: CDJ, HY. QLYLSAK@EC_E, DOI. M@EQ@Z, D@J. CZOYAD 700?0, N@S@ XAM_Z, AEHLEOYA@ XOK > +7:-60:921:2678

@YO@E-AEHA@ GZOO XZ@HO @ZO@

RZOGOZOEXA@K RZOGOZOEXA@ K X@ZAGG IOZXAGAI@XO LG LZACAE (Ilmjaeoh Hoik`r`tale `eh Iortagai`to) GLZM @A

:. Cllhs ile ilesaceoh saceoh ttl l (Iles (Ilesaceoo's aceoo's e`mo, e`mo, `hh `hhross, ross, i iluetry) luetry)

Assuoh ae AEHLEOYA@

JF@XX@IF@ZQ@ XAMJOZ ?:, JF_ROE JLYO @WOE_O YFQ@MJ@^@Z, DLKD@X@ - 322228 SOYX JOEC@K, AEHA@

(Iluetry) Yoo Eltos Lvorko`g

9. Mo`es lg tr`esplr tr`esplrtt `eh rrluto luto (`s (`s g`r `s delwe)

8. Glr Lgga Lggaia` ia`kk _so _so Rrogoroeta`k X`ragg Xro`tmoet Cavoe _ehor @YO@E-Aeha` Groo Xr`ho @ro` Rrogoroeta`k X`ragg

Hop`rturo H`to

M@Q 02, :2:0

Wo Wosso ssok'k's s e`m e`mo/@ o/@ar arir` ir`gt gt oti. oti.

M@OZYD M@OZYD Q@M Q@M_E _E@ @W W.0 .006E 06E

Rlrt lg Hasif`rco

DLKD@X@, AEHA@

Rrogoroeta`k X`ragg Xro`tmoet Elt Cavoe (Rko`so st`to ro`sle/s)

................................................................... ............................................ ............................................. ...................... Yace`turo lg @utflrasoh Yace`tlry lg tfo Amplrtaec Iluetry ?. Atom Atom eumjor

7. M` M`rrd s `eh `eh eumjors le R`id`cos

0

3. Eumjor `eh typo typo lg p`id`cos, hosiraptale hosiraptale lg lg cllhs (aeikuho qu`etaty wforo `pprlpra`to `eh FY eumjor lg tfo amplrtaec iluetry)

6. Lr Lrac acae ae irat irator oral ale e (soo Eltos lvorko`g)

: V :2' ILEX@AEOZY YXI > 90 J_EHKOY = 3,027 RIY = 91.971: IJM LG J@ECDAZ@A Y@SE YA^OY & J@ECDA@ZA O:O YA^OY CZ@HO-J FY ILHO > 8821.::.22

SL

00. Hoik`r` Hoik`r`tale tale jy tfo oxplrtor

Xfo uehorsaceoh forojy hoik`ros tf`t tfo `jlvo hot`aks `eh st`tomoet `ro ilrroit4 tf`t `kk tfo cllhs woro prlhuioh ae

1. Crlss Crlss woacf woacftt lr lr ltfo ltforr qu`etaty `eh v`kuo (GLJ)

91,971.:2 DCM _YH 07,2:6.38

02 02..

Eumj Eumjor or `e `eh h h`to lg Aevlaios

27/MZW-2?/AEW/  W/:2:0 M@Q 9, :2:0

0:.Iortagai`tale At as forojy iortagaoh, le tfo j`sas lg iletrlk i`rraoh lut, tf`t tfo hoik`r`tale jy tfo oxplrtor as ilrroit. AYY_AEC LGGAIO AE RZLWAEYA N@S@ XAM_Z

AEHLEOYA@ ........................................................ .......................... ........................................................... ................................................ ...................

(Iluetry) `eh tf`t tfoy ilmpky watf tfo lracae roquaromoets spoiagaoh glr tfoso cllhs ae tfo @YO@E-Aeha` Groo Xr`ho @ro` Rrogoroeta`k X`ragg glr tfo cllhs oxplrtoh tl

AEHA@................................................. ......................................................... ........................... ........................................................... .................... (Amplrtaec Iluetry)

CZOYAD, ...................................................................................... ......................................................... ................................................. .................... Rk`io `eh h`to, sace`turo lg `utflrasoh sace`tlry

, ............................................... ............................................... ........................ .............................................. ............................................... ......................... ..

Rk`io `eh h`to, sace`turo `eh st`mp lg iortagyaec `utflraty

09. Sforo `pprlpra`to pko`so taid> Xfarh Iluetry Aevlaiaec

Oxfajatale

J`id-tl-J`id IL

Iumuk`talR`co e 0/0