Весь документ

	
		
		
		
		
		
		
		
	
	

		

			

			
1. Consignor/exporter 

			

			(name and address) 
			
			

			
4. № 

			
CERTIFICATE OF ORIGIN OF GOODS  

			

			ST-2 FORM 
			
		
		

			

			
2. Consignee/importer  

			

			(name and address) 
			
			

			
Issued in _____________________________ 

			

			(Name of the country) 

			
For submitting in _____________________ 

			

			(Name of the country) 
			
		
		

			

			
3. Means of transport and itinerary (as far as is known) 
			
			

			
5. For official use/notes only 
			
		
		

			

			
6. № 
			
			

			
7. Number of pieces of goods and type of packing 
			
			

			
8. Description of goods 
			
			

			
9. Criteria of origin 
			
			

			
10. Quantity of goods 
			
			

			
11. Invoice number and date 
			
		
		

			

			
12. Certification 

			

			This is to certify, on the basis of implemented control, that the information contained in the Declaration of the applicant is true 

			

			

			

			

			

			

			 

			
__________________________ 

			

			Signature Date Seal 
			
			

			
13. Declaration of the applicant 

			

			The undersigned states that the above- mentioned information is true and that all goods have been completely produced or reprocessed well enough in 

			

			___________________________________ 

			

			(Name of the country) 

			
and that the goods meet the requirements of оrigin prescribed for such goods 

			

			

			

			

			

			______________________________________ 

			

			Signature Date Seal 
			
		
	

иметь:

размер 210 х 297 миллиметров, при этом по длине может

допускаться отклонение в большую сторону на 5 миллиметров или в