Приказ Министерства индустрии и торговли от 24.09.2008 N 374 "Об утверждении Правил определения страны происхождения товаров и выдачи сертификатов о происхождении товаров". Приложение 8. Форма 4
Приложение 8 к Правилам определения страны происхождения товаров и выдачи сертификатов о происхождении товаров
1. Exporter (name, address, country)
Original N certificate of origin Issued in the Republic of Kazakhstan
2. Consigned (name, address, country)
3. Means of transport and route
4. For official use
5. Country of origin
6. Supplementary details
7. Item number
8. Description of goods
9. Number and king of packages
10. Gross weight or other quantity
11. Certification It is herebery certified, that the declaration by the exporter is correct.
_____________________________ Place and date, signature and stamp of certifying authority
12. Declaration by the exporter. The undersigned hereby declares that the above details and statements are correct; that the goods are of the country shown in box 5; that the goods are exported to were __________________ (importing country) _______________________________ Place and date, signature of authority signatory