ORIGINAL 1, Goods Gonsigned trom (Exporters namo, adaress and Cortticate No. 190253973 Form AANZ country) NESTLE AUSTRALIA LTD BUILDING D/GROUND FLOOR, THOMEUaH ORY Cone AGREEMENT ESTABLISHING THE ASEAN — RHODES AUSTRALIA ~ NEW ZEALAND FREE TRADE NSW AREA (AANZFTA) AUSTRALIA 2. Goods Consigned onsignes's name, CERTIFICATE OF ORIGIN address, ‘come fo importers! Consia (Combined Declaration and Certificate) PT.NESTLE INDONESIA {sued in... AUSTRALIA... \WISMA NESTLE, ARKADIA OFFICE PARK. ‘(County) JLT SIMATUPANG KAV. 88 {IBKARTA 12520 (200 Overaat Notes) INDONESIA 3. Means of transport and route (if koown) 4. For Official Use ‘Shipment Date: 17/05/2010 1 Proferetia Treatment Given Under ANZFTA (OOCL CHARLESTON 162N Vossore name/Atreraft eo {0 Proferential Treatment Not Given (Please state Port of Discharge: SURABAYA reason/s) ‘Signature of Authorised Signatory a the Importing Country S.item | 6. Marks and | 7. Number and kind of packages; 8. Origin ‘9. Quantity (Gross weight or | 10. Invoice umber] numbers on | description of goods including HS | Gonferring_| other measurement), and | number(s) packages | Code (6 digits) and brand name (if Criterion (see | valve (FOB) where RVC is | and date of applicable). Name of company issuing | Overieaf applied (see Overlest Notes) | invoice(s) third party Invoteo (if applicable) Notes) 7 ]4882270600 _]40 PACKS;PRO PLAN PUPPY SMALL BR | RVC 42aKG) 1162178928 JED 4x2.5KG;HS 230910 2 [452279600 |80 PACKS;PRO PLAN KITTEN 4x2.5kG | RVC ‘58KG 10706119} HS 230010 3. [4882279000 |40 PACKS:PRO PLAN PUPPY sensitiv. | RVC 428K¢| 11, Declaration by the exporter 12, Certification ‘The undersigned hereby declares that the above dotalls | On the basis of control carried out, It Is hereby certified that the and statements are correct; that all the goods were | information herein is correct and that the goods described comply produced in withthe origin raqulromanta spectiod n the Agreement Establehing the ASEAN-AustraiaNew Zealand Free Trade Area. AUSTRALIA AUSTRALIAN CHAMBER OF COMMERCE AND INDUSTRY {country}, and tha they comply wit he rules of orga as providedin || | _ tows Camerata Auten ne a ACT 280 Ane Zhaptor 3 ofthe Aproomont Estabishing the ASEAN een i HE Rh oP i Australia-New Zealand Free Trade Area for the goods _Ausiorized to issue Corticates of Origin by Ure Government ofthe Commertweaith of Austala exported to a INooNESIA reycmee ™ 31 MAY 2019 f Gotu 1) 2119512019 PATRICIA GENOVA tesued at Sydney, NSW NESTLE AUSTRALIA ‘date, name, signature and ‘Baa’ and date, signature and stamp of Authorised lace: | company of authorised signatory Issuing Authority Body 43, [Back-to-back Certificate of Origin subject of third-party invoice issued retroactively ie minimis LnccumulationContinuation Sheet Contiticate No. 190253973 ORIGINAL Form ANZ tem 7, Number and kind of packages; 8. Origin 9, Quantity (Gross weight or | 10. invoice number description of goods includingHS | Conferring | othermeasurement},and | number(s) and Code (6 digits) and brandname (it | Criterion (see | valuo (FOB) where RVG is | date of invoice(s) applicable). Name of company issuing | Overleaf applied (see Overieat Notes) third party invoice (if applicable) Notes} IE DIGESTION 4x2 5KGIHS 250810 4 4552279600 _|72 PACKS:PRO PLAN ADULT DOG SENS | RVC e71.2K6| ITIVE DIGESTION 12KG:HS 280910 5 14852270600 |144 PACKS|PRO PLAN ADULT CAT CHI [RVC 020.9646 (CKEN 7KG:HS 230610 6 4852279600 |1008 PACKS:PROPLAN ADULT CAT SA. [RVC 148.72K6| Laon 7K65 230910 AUD 26740.1 MANUFACTURED BY NESTLE PURINA PETCARE AUSTRALIA 11, Declaration by the exporter 12, Certification The undersigned hereby declares that the above dotalis and | On the basis of control carried out, itis hereby certified that the AUSTRALIA (courte) and that they comply with the rules of origin, as provided in CChaptor 3 of the Agreement Establishing the ASEAN-Australia- Now Zealand Free Trade Area for the goods exported to INDONESIA ~Gimpering county) Fie avosrore PATRIA GeNOvA NESTLE AUSTRALIA Place and daie, name, signature and ‘company of authoriswd signatory Information herein Is correct and that the goods described comply with the origin requirements specified in the Agreement Establishing the ASEAN-Australia-New Zealand Free Trade Area. AG tovel3, Commerce Hau, 24 Srbanehverae Baton ACT. 2600, aaa "wosor inate wt ForaieTa 18 ‘Asnorina i lve Cacao gn Wa Governor the Conmonweath ot Asso uses rte Comece le 31 MAY 2019 fesued ai Sydney, NSW Pace and date, signature and stamp of Authorised Issuing Authority! Bod