(ASEEM KUMAR)
Under Secretary to the Government of India
Annexure-A
1. Goods consigned from (Exporters¡¯ Business Name, Address, Country) | Reference No. Duty Free Tariff Preference Scheme for Least Developed Countries (Combined declaration and certificate) Issued in¡¡¡¡¡¡¡¡¡¡. (Country) (See notes overleaf) |
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2. Goods consigned to (Consignee¡¯s Name, Address, Country) | 4. For Official use | ||||
3. Means of transport and route (as far as known) | |||||
5. Harmoni-sed System (HS) Code | 6. Marks and numbers 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 invoice |
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 those goods in Duty Free Tariff Preference Scheme for Least Developed Countries . ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡ (Importing Country) ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡ Place and date, signature of the authorised 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. |
Annexure-B
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