附件CERTIFICATE OF ORIGIN ORIGINAL1 ・ Exporter's n ame and address, coun try:Certificate No.:CERTIFICATE OF ORIGIN Form for Chi na-Korea FTAIssued in(see Overleaf In structi on)2. Producer's n ame and address, coun try*:3. Con sig nee's n ame and address, coun try:4. Means of tra nsport and route (as far as known): Departure Date:Vessel/Hight/Train/Vehicle No.:Port of load ing:Port of discharge:5 ・ Remarks:6. Item n umber (Max 20)7. Marks and Numbers on packages8. Number and ki nd of packages; descripti on of goods9. HS code (Six-digit code)10. Origin criterio n11 ・ Gross weight, qua ntity (Qua ntity Un it) or other measures (liters, m3, etc.)12. Number and date of in voice13. Declarati on by the exporter:The un dersig ned hereby declares that the above details and statement are correct, that all the goods were produced in(Cou ntry)and that they comply with the orig in requireme nts specified in the FTA for the goods exported to(Import ing coun try)Place and date, sig nature of authorized sig natorv14. Certificatio n:On the basis of con irol carried out. it is hereby certified that the inf ormati on here in is correct and that the goods described comply with the origin requirements specified in the China-Korea FTA ・Place and date, sig nature and stamp of authorized bodyOverleaf InstructionCertificate No.: Serial number of Certificate of Origin assigned by the autliorized body.Box I: State the full leg" n ame and address (in clud ing coun try ) oilhe exporter in eitlier China or KoreaBox 2: State llie full legal name and address (including countn) oithc pnxlucer. If goods from more thanone producer are included in the certificate, list the additional producers, iricluding tlieir full legal name and address (including country). If the exporter or the producer wishes to maintai n this information as confidential, it is acceptable to state "AVAILABLE UPON REQUEST" If the producer and the exporter are (he same, please complete field with "SAME."Box 3: State the full legal name and address (including coiintiy) o1 the consignee resident in either Koreaor China・Box 4: Complete the means of transport and route and specify the departure date, transport vehicle No.,port of loading and port of discharge.Box 5: In case where a good is invoiced by a non-Party operator, the full legal name, country of then on-Party operator sliall be indicated in this box. In case of issuance of certificates retroactively, should bear the words “ISSUED RETROACTIVELY： and in case of a certified true copy, should bear the words "CERTIFIED TRUE COPY of the origi nal Certificate of Origin number _dated_Box 6: State the item number, and the number of items slx)uld not exceed 20.Box 7: State the shipping marks and numbers on packages, when such marks and numbers exist if theshipping marks are images or symbols, other than letter or numerical number, shall state IMAGE OR SYMBOL (l/Sy\otherwise shall state “NO MARKS AND NUMBERS(NZM 广Box 8: Ibe number and kind of packages shall be specified ・ Provide a full description of each good. Thedescription sliould be sufficiently detailed to enable tl)e goods to be identified by the Customs Officers examining them and relate them to the invoice description and to the IIS description of the good. If the goods are not packed, state “IN BULK"Box 9: For each good described in Box & identify the HS tariff classification to six-digit.lems which would indicate exact quantities may be used when customary.Box 12: Invoice number and date of invoice sliould be shown here. In case where a good is invoiced by anon-Pari)A operator and the n umber and date of the commercial in voice is unknown, the n umber and date of the original commercial invoice, issued in tl)e exporting Part)； shall be indicated in tliis box.Box 13: This box shall be completed, signed and. dated by the exporter.Box 14: Ibis box shall be completed ・ signed, dated, and stamped by the authorized person of theauthorized body.Box 10: lhe exporter must indicate in Box 10 the origin criteria on the basis of which he claims that theOrigin CriteriaIn sert i n Box 10The good is wholly obta ined or produced en tirely in a Parly, as set out and defi ned in Article 3.4 (Goods Wholly Obta ined or Produced) or required so in Annex 3- A (Product Specific Rules of Origi n).W()The good is produced en tirely in a Party, exclusively from materials whose orig in confbnns to Chapter 3 (Rules of Origin and Origin 1 moleme ntatio n Procedures).WPThe good is produced in a Part); using non-orig in at ing materials that confonn to a cha nge in tarift'classiflcati on, a regi onal value content a precess requireme nt or other requireme nts specified in Annex 3-A (Product Specific Rules of Orig in).PSRThe good is subject to Article 33 (Treatme nt of Certa in goods)OPgoods qualitx tor prefere ntial tariff trcatme ni in die manner sliow n in the follow in。