India-Australia Economic Cooperation and Trade Agreement

(ELECTRONIC COPY)

1. Exporter's Name, Address and Country:

Certification No.:

Number of page:

2. Producer's Name, Address and Country:

INDIA-AUSTRALIA ECONOMIC COOPERATION

AND TRADE AGREEMENT (Ind-Aus ECTA)

CERTIFICATE OF ORIGIN

3. Importer's or Consignee's Name, Address and Country:

4. Transport details:

5. Item Number ( as necessary ); Marks and numbers; Number

and Kind of packages; Description of good(s); HS Code (six-

digit level)

6. Origin criteria 7. Gross weight

or other quantity

8. Invoice number(s)

and date(s)

9. Remarks (if applicable):

ISSUED RETROSPECTIVELY

10. Non-Party Invoicing Name, Address, and Country (if applicable):

11. Declaration by the exporter:

I, the undersigned, declare that: - the above details and

statement are true and accurate; - the good(s) described above

meet the condition(s) required for the issuance of this certificate:

and - the country of origin of the good(s) described above is:

INDIA

Place and Date:

Name :

Company :

12. Certification:

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 issuing authority.

SAMPLE

Overleaf Notes:

The following origin criterion code should be inserted in Box 6:

(i) “WO” for wholly obtained or produced goods as provided in the Article 4.4;

(ii) “PSR” for product specific rules as provided in Annexure- 4B;

(iii) “CTSH + QVC 35 or 45 % (Build-up/ Build-down as the case may be)” for goods satisfying conditions mentioned in

the Article 4.3.1.

'Export Document Number' here refers to:

(i) Shipping Bill (Export Declaration) Number and date; or

(ii) Transport Document (Bill of lading/ Airway Bill) Number and date.

The Export Document Number shall be required only if the export document is issued prior to the filing of the application for

the Certificate of Origin.

SAMPLE