Certificate of Origin Template

Name of Exporter ……………………………..

Address ………………………………………………

Name of Shipping Company ……………………..

Address ……………………………………….

Invoice Numbers …………………………..

File Numbers …………………………….

Name of Consignee ………………………..

Address …………………………………………

Location …………………………………………….

Transport Information ………………………………

Shipping Number ………………………………………..

Description of Merchandise ………………………

Particulars of Merchandise ………………………………..

Quantity of Merchandise …………………………..

Weight of Merchandise …………………………..

Invoice Information ……………………………….

The authorizing official hereby acknowledges the specified country of origin of the merchandise.