Export – What, Where, How

Annexure 40

Format of the Certificate of Origin (Non Preferential)

1. Goods consigned from (Exporter's business name, Reference No.
address, country)
CERTIFICATE OF ORIGIN
2. Goods consigned to (Consignee's name, address, (NON PREFERENTIAL)
country) (Combined declaration and certificate)

Issued in India
3. Means of transport and route (as far as known) 4. For official use
5. item 6. Marks and 7. Number and kind 8. Origin 9. Gross weight 10. Number
number numbers of of packages, criteria or other quantity and date of
packages description of goods invoices
11. Certification 12. Declaration by the exporter
It is hereby certified, on the basis of control carried The undersigned hereby declares that the above
out, that the declaration by the exporter is correct. details and statements are correct; that all the goods
were produced in India
and that they comply with the origin requirements for
exports to
……………………………………………………………..
(importing country)

……………..……………..……………..……………..…
Place and date signature and stamp of authorised ……………..……………..……………..……………..…
signatory Place and date signature of authorised signatory

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