1.

Goods Consigned from (Exporters name, address and

country)
ABC FURNITURE JSC- BINH DUONG BRANCH 2
BA TRI HAMLET, TAN HIEP COMMUNE,
TAN UYEN DISTRICT, BINH DUONG PROVINCE,
VIETNAM

2. Goods Consigned to (Importers/ Consignees name,

address, country)
INTERNATIONAL FURNITURE PTY LTD
120 BARRY ROAD, CAMPBELLFIED, VIC 3061
MELBOURNE AUSTRALIA

Certificate No.
VN-AU 15/06/01402

Form AANZ

AGREEMENT ESTABLISHING THE

ASEAN-AUSTRALIA-NEW
ZEALAND FREE TRADE AREA
(AANZFTA)
CERTIFICATE OF ORIGIN
(Combined Declaration and Certificate)
Issued in .........VIETNAM
(Country)
(see Overleaf Notes)

4. For Official Use

3. Means of transport and route (if known)
BY SEA, FROM HO CHI MINH PORT, VIETNAM
Shipment Date:
1 JUN 2015
Vessels name/Aircraft etc:
WAN HAI 271
Port of Discharge:
MELBOURNE, AUSTRALIA
5. Item
number

6. Marks and
numbers on
packages

7. Number and kind of packages;

description of goods including
HS Code (6 digits) and brand
name (if applicable)

184

WOODEN FURNITURE AS PER

NO M2052

Preferential Treatment Given Under AANZFTA

Preferential Treatment Not Given (Please state

reason/s)

Signature of Authorised Signatory of the Importing Country

8. Origin
9. Quantify (Gross weight or
10. Invoice
Conferring
other measurement), and value number(s) and
Criterion
(FOB) (see Overleaf Notes)
date of
(see overleaf
invoice(s)
notes)
PSR (CTC)

G.W: 5,215.00 KGS

TOTAL FOB:
USD 15,618.41

021-TT2-IF
2015
DATE: 1 JUN,
2015

SAY TOTAL: UNITED STATE DOLLARS FIFTEEN THOUSAND SIX HUNDRED EIGHTTEEN AND CENTS FORTY ONE ONLY

11. Declaration by the exporter

12. Certification

The undersigned hereby declares that the above details and

statements are correct; that all the goods were produced in

On the basis of control carried out, it is hereby certified

that the information herein is correct and that goods
described comply with the origin requirement specified in
the Agreement Establishing the ASEAN-Australia-New
Zealand Free Trade Area.

VIETNAM

and that they comply with the rules of origin, as provided in Chapter
3 of the Agreement Establishing the ASEAN-Australia-New Zealand
Free Trade for the goods exported to
AUSTRALIA
(importing country)

Place and date, signature and stamp of Authorised

Issuing Authority/Body

Place and date, name, signature and company of authorized

signatory.
13. Back-to-back Certificate of Origin
Subject of third-party invoice
Accumulation
De Minimis

Issued retroactively