Anexa nr.

2
la Regulamentul cu privire
la regulile de origine a mrfurilor

CERTIFICAT DE ORIGINE A MRFURILOR

CERTIFICATE OF GOODS ORIGIN

1. Exportator (denumirea, adresa complet, ara) CERTIFICAT nr.

Exporter (name, address, country) CERTIFICAT nr.
3. Emis n ara
2. Destinatar (denumirea, adresa complet,
Issued in
ara) Consignee (name, address, country)
country__________________________________________
4. Informaii privind transportul 5. Observaii ale autoritilor competente
Information of transport Remarks of a Competent Authority

8. Numrul i natura
7. Marcarea ambalajelor 10. Greutatea brut sau alte
9. Criteriul de 11. Numrul i data
coletelor Denumirea mrfurilor uniti de msur
6. Nr. crt origine facturilor
Packing & Number & Gross weight or other
Origin criteria Invoice Nr.& date
Marking Tupe of Packing measurement units
Goods name

13. Declaraia exportatorului

12. Viza Export
Signature DeclarationSubsemnatul declar c mrfurile declarate mai sus
Prin prezenta se confirm veridicitatea declaraiei ndeplinesc condiiile cerute pentru obinerea certificatului
exportatorului The undersigned declares that the goods declared above are
Confirms the authenticity of export declaration in conformity with the requirements necessary for obtaining
Certificate

___________________ LoculPlace_______________ DataData___________________

Locul, data, semntura i tampila autoritilor

competente Semntura i tampila
Place, date, signature and seal of a competent Signature and seal
authority