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.......................................................................................\cell }\pard \widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1018\trkeep \clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx5688\clmgf\clvertalt\clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw30 \cltxlrtb \cellx8078 \clmrg\clvertalt\clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb \cellx10634\pard \fi-340\li340\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 3.\tab Consignee }{ \fs18 (Name, full adress, country) (Optional)\cell }\pard \widctlpar\intbl\tqc\tx2271\adjustright {\fs16 \tab }{\b\fs18 and \par }\pard \widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs16 \par }\pard \fi-340\li340\widctlpar\intbl\tx359\tqr\tldot\tx4522\adjustright {\fs16 \tab \tab ....................................................................................... \par }\pard \widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs16 (Insert appropriate countries, groups of countries or territories)\cell \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1018\trkeep \clvertalt\clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx5688\clvertalt\clbrdrt \brdrs\brdrw30 \clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx8078\clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10634\pard \widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 \cell }\pard \fi-340\li340\widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 4.\tab Country, group of countries or territory in which the products are considered as originating \par }{\fs18 \par }\pard \qj\widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs18 \cell }\pard \fi-340\li340\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 5.\tab Country, group of countries or territory of destination}{\fs18 \par }\pard \qj\widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs18 \par \par \par \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1018\trkeep \clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \cltxlrtb \cellx5688\clmgf\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl \brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \cltxlrtb \cellx8078\clmrg\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10634\pard \fi-340\li340\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 6.\tab Transport details}{\fs18 (Optional) \par }\pard \widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs18 \par \par \par \par \par \par \cell }\pard \fi-340\li340\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 7.\tab Remarks}{ \fs18 \par }\pard \widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs18 \par \par \par \par \par \par \cell }{\fs16 \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1021\trkeep \clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \cltxlrtb \cellx7134\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl \brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx8816\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10637\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 8.\tab Item number; Marks and numbers; Number and kind of packages }{\cs20\b\fs18\super ({\footnote \pard\plain \s19\widctlpar\adjustright \f1 {\cs20\super (1)}{ }{\fs16 If goods are not packed, indicate number of articles or state \'ab\~in bulk\~\'bb as appropriate}}1)}{\b\fs18 ; Description of goods}{\fs18 \par }\pard \sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \cell }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 9.\tab Gross mass (kg) or other measure (litres, m}{\b\fs18\super 3}{\b\fs18 ., etc.)}{\fs18 \par }\pard \sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \cell }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 10.\tab Invoices}{ \fs18 \par \tab (Optional) \par }\pard \sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1021\trkeep \clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \cltxlrtb \cellx6409\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \cltxlrtb \cellx10377\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10637\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 11. CUSTOMS ENDORSEMENT \par }{\i\fs18 Declaration certified \par }\pard \sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 Export document }{ \cs20\fs18\super ({\footnote \pard\plain \s19\widctlpar\adjustright \f1 {\cs20\super (2)}{\fs16 .Complete only where the regulations of the exporting country or territory require.}}2)}{\fs18 \par }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 Form ..................................N}{\fs16 o}{\fs18 \'85.\'85\'85... \par Of \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85. \par Customs office .................................\'85\'85 \par Issuing country or territory ...................... \tab \tab Stamp \par ................................................................... \par ................................................................... \par Place and date \'85\'85\'85\'85\'85...................... \par ................................................................... \par \'85\'85............................................................}{\fs18\lang1026 \par }\pard \fi-340\li340\sa200\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 }{\fs16 (Signature)\cell }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 12. DECLARATION BY THE EXPORTER \par }\pard \qj\li163\sl127\slmult0\widctlpar\intbl \tx163\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 I, the undersigned, declare that the goods described above meet the conditions required for the issue of this certificate. \par \par \par Place and date \'85\'85\'85\'85\'85\'85........................ \par \par \par \par .......................................................................... \par }{\fs16 (Signature)\cell }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\pard \qc\sl330\slmult0\widctlpar\tqc\tx4734\adjustright {\page \par }\trowd \trqr\trgaph120\trleft1021\trkeep \clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx5865\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10377\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 13. REQUEST FOR VERIFICATION, to \par \cell }\pard \qj\li22\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 14. RESULT OF VERIFICATION\cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1021\trkeep \clvertalt\clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \cltxlrtb \cellx5865\clvertalt\clbrdrl\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10377\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \cell }\pard \qj\fi22\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 Verification carried out shows that this certificate }{\fs18\super (1) \par }\pard \qj\fi23\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18\super \par }\pard \qj\fi23\sb120\sl127\slmult0\widctlpar\intbl \tx22\tx305\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {{\field{\*\fldinst SYMBOL 168 \\f "Wingdings (PCL6)" \\s 10}{\fldrslt\f75\fs20}}}{\fs18 was issued by the customs office indicated and \par }\pard \qj\fi22\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 that the information contained therein is accurate. \par }\pard \qj\fi23\sa120\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par }\pard \qj\fi22\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {{\field{\*\fldinst SYMBOL 168 \\f "Wingdings (PCL6)" \\s 10}{\fldrslt\f75\fs20}}}{\fs18 does not meet the requirements as to authenticity \par and accuracy (see remarks appended). \par \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1021\trkeep \clvertalt\clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \cltxlrtb \cellx5865\clvertalt\clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10377\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par }\pard \sl127\slmult0\widctlpar\intbl \tx0\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 Verification of the authenticity and accuracy of this certificate is requested. \par }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \par \par ...............................................\'85\'85\'85\'85\'85................................. \par }\pard \qc\fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 (Place and date) \par }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \par \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab }{\fs16 Stamp \par }{\fs18 \par .....................................................\'85\'85 \par }\pard \qc\fi-340\li340\ri1723\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2740\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 (Signature) \par }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \cell }\pard \qj\fi22\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \par \par \par \par \par .........................................\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85.. \par }\pard \qc\fi22\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 (Place and date) \par }\pard \qj\fi22\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \tab \tab \tab \tab \tab \tab \tab \tab \tab }{\fs16 Stamp \par }\pard \qj\fi22\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \par }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 .....................................................\'85 \par }\pard \qc\fi-340\li340\ri1699\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2715\tx2857\tx3396\tx3735\tx4075\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 (Signature) \par }\pard \qj\fi22\sl127\slmult0\widctlpar\intbl \tx22\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 _____________ \par (1) Insert X in the appropriate box.\cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\pard \qc\sl330\slmult0\widctlpar\tqc\tx4734\adjustright { \par \par }\pard \qc\sa120\sl330\slmult0\widctlpar\tqc\tx4734\adjustright {\b NOTES \par }\pard \qj\fi-426\ri-144\sl220\slmult0\widctlpar\tqc\tx4734\adjustright {1.\tab }{\fs18 Certificate must not contain erasures or words written over one another. Any alterations must be made by deleting the incorrect particulars and adding any necessary corrections. Any such alteration must be initialled by the person who completed the certif icate and endorsed by the Customs authorities of the issuing country or territory. \par \par 2.\tab No spaces must be left between the items entered on the certificate and each item must be precede by an item number. A horizontal line must be drawn immediately below the last item. Any unused space must be struck through in such a manner as to make any later additions impossible. \par \par 3.\tab Goods must be described in accordance with commercial practice and with sufficient detail to enable them to be identified. \par }\pard \qc\widctlpar\adjustright {\page }{\b\fs19 APPLICATION FOR A MOVEMENT }{\b CERTIFICATE}{\fs16 \par }\trowd \trqr\trgaph120\trleft1018\trkeep \clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx5688\clmgf\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx8078\clmrg\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrr \brdrs\brdrw15 \cltxlrtb \cellx10634\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 1.\tab Exporter }{ \fs18 (Name, full address, country)\cell }\pard \fi-3396\li3396\sb60\sa60\sl240\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 \tab \tab }{\b\fs28 EUR.1}{\b \tab \tab \tab }{\b\fs16 No}{\b }{\b\fs28 A}{\fs16 \tab }{000.000}{\fs16 \cell }\pard \sl240\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1018\trkeep \clvertalt\clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx5688\clmgf\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw30 \cltxlrtb \cellx8078 \clmrg\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10634\pard \sl240\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 \cell }\pard \qc\sb120\sa120\sl240\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 See notes overleaf before completing this form.\cell }\pard \qc\sl240\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1018\trkeep \clvertalt\clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx5688\clmgf\clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \cltxlrtb \cellx8078\clmrg\clvertalt\clbrdrt \brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb \cellx10634\pard \sl240\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 \cell }\pard \fi-340\li340\sb48\sl192\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 2.\tab Application for a certificate to be used in preferential trade between}{\fs18 \par }\pard \fi-340\li340\sb32\widctlpar\intbl\tx359\tqr\tldot\tx4522\adjustright {\fs18 \tab \tab .......................................................................................\cell }\pard \widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1018\trkeep \clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx5688\clmgf\clvertalt\clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw30 \cltxlrtb \cellx8078 \clmrg\clvertalt\clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb \cellx10634\pard \fi-340\li340\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 3.\tab Consignee}{ \fs18 (Name, full adress, country) (Optional)\cell }\pard \widctlpar\intbl\tqc\tx2271\adjustright {\fs16 \tab }{\b\fs18 and}{\fs18 \par }\pard \widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs16 \par }\pard \fi-340\li340\widctlpar\intbl\tx359\tqr\tldot\tx4522\adjustright {\fs16 \tab \tab ....................................................................................... \par }\pard \qc\widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs16 (Insert appropriate countries or groups of countries or territories)\cell }\pard \widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1018\trkeep \clvertalt\clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx5688\clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw15 \cltxlrtb \cellx8078\clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl \brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10634\pard \widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 \cell }\pard \fi-340\li340\widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 4.\tab Country, group of countries or territory in which the products are considered as originating \par }\pard \qj\widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs18 \cell }\pard \fi-340\li340\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 5.\tab Country, group of countries or territory of destination}{\fs18 \par }\pard \qj\widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs18 \par \par \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1018\trkeep \clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \cltxlrtb \cellx5688\clmgf\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl \brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \cltxlrtb \cellx8078\clmrg\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10634\pard \fi-340\li340\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 6.\tab Transport details}{\fs18 (Optional) \par }\pard \widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs18 \par \par \par \par \par \par \cell }\pard \fi-340\li340\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 7.\tab Remarks}{ \fs18 \par }\pard \widctlpar\intbl\tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright { \fs18 \par \par \par \par \par \par \cell }{\fs16 \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\trowd \trqr\trgaph120\trleft1021\trkeep \clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \cltxlrtb \cellx7134\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl \brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx8816\clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \cltxlrtb \cellx10637\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 8.\tab Item number; Marks and numbers; Number and kind of packages }{\b\fs18\super (1) }{\b\fs18 Description of goods}{\fs18 \par }\pard \sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \cell }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 9.\tab Gross mass (kg) or other measure (litres, m}{\b\fs18\super 3}{\b\fs18 ., etc.)}{\fs18 \par }\pard \sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \cell }\pard \fi-340\li340\sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\b\fs18 10.\tab Invoices}{ \fs18 \par \tab (Optional) \par }\pard \sl127\slmult0\widctlpar\intbl \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs18 \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \par \cell }\pard \widctlpar\intbl\adjustright {\fs16 \row }\pard \sl127\slmult0\widctlpar \tx0\tx339\tx679\tx1019\tx1358\tx1698\tx2037\tx2377\tx2717\tx3056\tx3396\tx3735\tx4075\tx4415\tx4754\tx5094\tx5433\tx5773\tx6113\tx6452\tx6792\tx7131\tx7471\tx7811\tx8150\tx8490\tx8829\tx9169\tx9509\tx9848\tx10188\adjustright {\fs16 (1) If goods are not packed, indicate number of articles or state \'ab\~in bulk\~\'bb as appropriate \par }\pard \qc\sl330\slmult0\widctlpar\tqc\tx4734\adjustright {\page }{\b\fs22 DECLARATION BY THE EXPORTER}{\fs22 \par }\pard \sl330\slmult0\widctlpar\tx0\tx397\tx794\tx1192\tx1589\tx1986\tx2383\tx2780\tx3178\tx3575\tx3972\tx4369\tx4766\tx5164\tx5561\tx5958\tx6355\tx6752\tx7150\tx7547\tx7944\tx8341\tx8738\tx9136\tx9533\adjustright { \par \par }\pard \qj\sl330\slmult0\widctlpar\tx0\tx397\tx794\tx1192\tx1589\tx1986\tx2383\tx2780\tx3178\tx3575\tx3972\tx4369\tx4766\tx5164\tx5561\tx5958\tx6355\tx6752\tx7150\tx7547\tx7944\tx8341\tx8738\tx9136\tx9533\adjustright { I, the undersigned, exporter of the goods described overleaf, \par \par }\pard \qj\fi-1589\li1589\sl330\slmult0\widctlpar\tx0\tx397\tx794\tx1192\tx1986\tx2383\tx2780\tx3178\tx3575\tx3972\tx4369\tx4766\tx5164\tx5561\tx5958\tx6355\tx6752\tx7150\tx7547\tx7944\tx8341\tx8738\tx9136\tx9533\adjustright {DECLARE\tab that the goods meet the conditions required for the issue of the attached certificate; \par }\pard \qj\sl330\slmult0\widctlpar\tx0\tx397\tx794\tx1192\tx1589\tx1986\tx2383\tx2780\tx3178\tx3575\tx3972\tx4369\tx4766\tx5164\tx5561\tx5958\tx6355\tx6752\tx7150\tx7547\tx7944\tx8341\tx8738\tx9136\tx9533\adjustright { \par }\pard \qj\fi-1589\li1589\sl330\slmult0\widctlpar\tx0\tx397\tx794\tx1192\tx1589\tx1986\tx2383\tx2780\tx3178\tx3575\tx3972\tx4369\tx4766\tx5164\tx5561\tx5958\tx6355\tx6752\tx7150\tx7547\tx7944\tx8341\tx8738\tx9136\tx9533\adjustright {SPECIFY\tab as follows the circumstances which have enable these goods to meet the above conditions: \par }\pard \qj\fi1134\sl330\slmult0\widctlpar\tqr\tldot\tx9468\adjustright {\tab \par \tab \par \tab \par \tab \par }\pard \qj\sl330\slmult0\widctlpar\tx0\tx397\tx794\tx1192\tx1589\tx1986\tx2383\tx2780\tx3178\tx3575\tx3972\tx4369\tx4766\tx5164\tx5561\tx5958\tx6355\tx6752\tx7150\tx7547\tx7944\tx8341\tx8738\tx9136\tx9533\adjustright { \par SUBMIT\tab \tab the following supporting documents (}{\cs20\super \chftn {\footnote \pard\plain \s19\widctlpar\adjustright \f1 {\cs20\super \chftn }{ \tab For example\~: import documents, movement certificates, invoices, manufacturer\rquote s declarations, etc., referring to the products used in manufacture or to the goods re-exported in the same state.}}}{): \par }\pard \qj\fi1134\sl330\slmult0\widctlpar\tqr\tldot\tx9468\adjustright {\tab \par \tab \par \tab \par \tab \par }\pard \qj\fi1134\sl330\slmult0\widctlpar\tx0\tx397\tx794\tx1192\tx1589\tx1986\tx2383\tx2780\tx3178\tx3575\tx3972\tx4369\tx4766\tx5164\tx5561\tx5958\tx6355\tx6752\tx7150\tx7547\tx7944\tx8341\tx8738\tx9136\tx9533\adjustright { \par }\pard \qj\fi-1276\li1276\ri-428\sb110\widctlpar\tx0\tx397\tx794\tx1986\tx2383\tx2780\tx3178\tx3575\tx3972\tx4369\tx4766\tx5164\tx5561\tx5958\tx6355\tx6752\tx7150\tx7547\tx7944\tx8341\tx8738\tx9498\tx9533\adjustright {UNDERTAKE\tab to submit, at the request of the appropriate authorities, any supporting evidence which these authorities may require for the purpose of issuing the attached certificate, and undertake, if required, to agree to any inspection of my accounts and to any che ck on the processes of manufacture of the above goods, carried out by the said authorities; \par }\pard \qj\widctlpar\tx0\tx397\tx794\tx1192\tx1589\tx1986\tx2383\tx2780\tx3178\tx3575\tx3972\tx4369\tx4766\tx5164\tx5561\tx5958\tx6355\tx6752\tx7150\tx7547\tx7944\tx8341\tx8738\tx9136\tx9533\adjustright { \par REQUEST\tab the issue of the attached certificate for these goods. \par \par }\pard \widctlpar\tx0\tx397\tx794\tx1192\tx1589\tx1986\tx2383\tx2780\tx3178\tx3575\tx3972\tx4369\tx4766\tx5164\tx5561\tx5958\tx6355\tx6752\tx7150\tx7547\tx7944\tx8341\tx8738\tx9136\tx9533\adjustright { \par }\pard \qj\widctlpar\tx4252\tldot\tx7086\tqr\tldot\tx9468\adjustright {\tab \tab .\tab \par }\pard \qc\li4253\widctlpar\tx4252\tldot\tx7086\tqr\tldot\tx9468\adjustright {(Place and date) \par }\pard \widctlpar\tx4252\tldot\tx7086\adjustright {\tab \par \par }\pard \widctlpar\tx4252\tqr\tldot\tx9468\adjustright {\tab .\tab \par }\pard \widctlpar\tqc\tx6803\adjustright {\tab (Signature) \par }\pard \widctlpar\adjustright { \par \par \par \par \par \sect }\sectd \pgwsxn11907\pghsxn18144\marglsxn1296\margrsxn1296\margtsxn1152\margbsxn1440\psz1\pgnrestart\linex0\headery709\footery1152\colsx709\titlepg\sectdefaultcl {\footer \pard\plain \s15\widctlpar\tqc\tx4320\tqr\tx8640\adjustright \fs20\lang2057 { \par }}\pard\plain \qj\li-1008\ri-1008\sa270\widctlpar\tx-1008\tqc\tx4680\tx5040\hyphpar0\adjustright \fs20\lang2057 {\b\fs24\expnd0\expndtw-3\lang1024 \tab }{\b\f344\fs24\lang1026 \'c4\'c5\'ca\'cb\'c0\'d0\'c0\'d6\'c8\'df \'cd\'c0 \'c8\'c7\'cd\'ce\'d1\'c8\'d2 \'c5\'cb\'df \par }\pard \qc\widctlpar\adjustright {\b\fs24\lang1026 \par \par }\pard \qj\widctlpar\adjustright {\f344\fs24\lang1026 \tab \'c0\'e7, \'e4\'ee\'eb\'f3\'ef\'ee\'e4\'ef\'e8\'f1\'e0\'ed\'e8\'ff\'f2 \'e8\'e7\'ed\'ee\'f1\'e8\'f2\'e5\'eb \'ed\'e0 \'f1\'f2\'ee\'ea\'e8\'f2\'e5, 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{\fs24\lang1026 \par \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85. \par \par }{\f344\fs24\lang1026 \'cf\'d0\'c8\'cb\'c0\'c3\'c0\'cc \'f1\'eb\'e5\'e4\'ed\'e8\'f2\'e5 \'ef\'ee\'f2\'e2\'fa\'f0\'e6\'e4\'e0\'e2\'e0\'f9\'e8 \'e4\'ee\'ea\'f3\'ec\'e5\'ed\'f2\'e8}{\cs20\fs24\lang1026\super \chftn {\footnote \pard\plain \s19\qj\widctlpar\adjustright \f1 {\cs20\f0\super \chftn }{\f0 }{\f344\lang1026 \'cd\'e0\'ef\'f0\'e8\'ec\'e5\'f0: \'e4\'ee\'ea\'f3\'ec\'e5\'ed\'f2\'e8 \'e7\'e0 \'e2\'ed\'ee\'f1, \'f1\'e5\'f0\'f2\'e8\'f4\'e8\'ea\'e0\'f2\'e8 \'e7\'e0 \'e4\'e2\'e8\'e6\'e5 \'ed\'e8\'e5 \'ed\'e0 \'f1\'f2\'ee\'ea\'e8\'f2\'e5, \'e4\'e5\'ea\'eb\'e0\'f0\'e0\'f6\'e8\'ff \'ed\'e0 \'ef\'f0\'ee\'e8\'e7\'e2\'ee\'e4\'e8\'f2\'e5\'eb\'e8\'f2\'e5 \'e8 \'e4\'f0., \'f1\'e2\'fa\'f0\'e7\'e0\'ed\'e8 \'f1 \'ef\'f0\'ee\'e4\'f3\'ea\'f2\'e8\'f2 \'e5 \'e8\'e7\'ef\'ee\'eb\'e7\'e2\'e0\'ed\'e8 \'e2 \'ef\'f0\'ee\'e8\'e7\'e2\'ee\'e4\'f1\'f2\'e2\'ee\'f2\'ee \'e8\'eb\'e8 \'f1\'fa\'f1 \'f1\'f2\'ee\'ea\'e8\'f2\'e5 \'f0\'e5\'e5\'ea\'f1\'ef\'ee\'f0\'f2\'e8\'f0\'e0\'ed\'e8 \'e2 \'f1\'fa\'f9\'e0\'f2\'e0 \'e4 \'fa\'f0\'e6\'e0\'e2\'e0.}{\f0 \par }}}{\fs24\lang1026 : \par \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85. \par \par }{\f344\fs24\lang1026 \'c7\'c0\'c4\'da\'cb\'c6\'c0\'c2\'c0\'cc \'d1\'c5 \'e4\'e0 \'ef\'f0\'e5\'e4\'f1\'f2\'e0\'e2\'ff, \'ef\'ee \'ec\'ee\'eb\'e1\'e0 \'ed\'e0 \'f1\'fa\'ee\'f2\'e2\'e5\'f2\'ed\'e8\'f2\'e5 \'e2\'eb\'e0\'f1\'f2\'e8, \'e2\'f1\'ff\'ea\'e0\'ea \'e2\'e8 \'ef\'ee\'f2\'e2\'fa\'f0\'e6\'e4\'e0\'e2\'e0\'f9\'e8 \'e4\'ee\'ea\'e0\'e7\'e0\'f2\'e5\'eb\'f1\'f2\'e2\'e0, \'ea\'ee\'e8\'f2\'ee \'f2\'e5\'e7\'e8 \'e2\'eb\'e0\'f1\'f2\'e8 \'ec\'ee\'e3\'e0\'f2 \'e4\'e0 \'e8\'e7\'e8\'f1\'ea\'e0\'f2 \'e7\'e0 \'f6\'e5 \'eb\'e8\'f2\'e5 \'ed\'e0 \'e8\'e7\'e4\'e0\'e2\'e0\'ed\'e5 \'ed\'e0 \'ef\'f0\'e8\'eb\'ee\'e6\'e5\'ed\'e8\'ff \'f1\'e5\'f0\'f2\'e8\'f4\'e8\'ea\'e0\'f2 \'e8 \'f1\'e5 \'e7\'e0\'e4\'fa\'eb\'e6\'e0\'e2\'e0\'ec, \'e0\'ea\'ee \'f2\'ee\'e2\'e0 \'f1\'e5 \'e8\'e7 \'e8\'f1\'ea\'e2\'e0, \'e4\'e0 \'f1\'e5 \'f1\'fa\'e3\'eb\'e0\'f1\'ff \'ed\'e0 \'e2\'f1\'ff\'ea\'e0 \'ef\'f0\'ee\'e2\'e5\'f0\'ea\'e0 \'ed\'e0 \'ef\'f0\'ee\'e8\'e7\'e2\'ee\'e4\'f1\'f2\'e2\'e5\'ed\'e8\'ff \'ef\'f0\'ee\'f6\'e5\'f1 \'ed\'e0 \'e3\'ee\'f0\'e5 \'ef\'ee\'f1\'ee\'f7\'e5\'ed\'e8\'f2\'e5 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