附件 1 中国—瑞士自贸协定项下原产地证书（中国）格式 CERTIFICATE OF ORIGIN 1. Exporter (Name, full address, country) No. 000.000 Certificate of Origin used in FTA between 2. Consignee (Name, full address, country) CHINA and SWITZERLAND See notes overleaf before completing this form 3. Transport details (as far as known) 4. Remarks Departure Date Vessel / Flight/ Train/ Vehicle No. Port of loading Port of discharge 5. Item 6. Marks and 7. Number and kind of 8. HS code (Six 9. Origin 10. Gross 11. Invoices number numbers packages; Description of digit code) criterion mass (kg) or (Number and (Max 50) goods other date) measure (liters, m3, etc.) 12. ENDORSEMENT BY THE AUTHORISED BODY 13. DECLARATION BY THE EXPORTER It is hereby certified, on the basis of control carried out, The undersigned hereby declares that the details that the declaration of the exporter is correct. and statement above are correct, that all the goods were produced in ………………………………….. (country) and that they comply with the origin requirements specified in the FTA for the goods exported to …………………………………..(Importing country). ……................................................................................. Place and date, signature and stamp of authorised body ................................................................................... Place and date, signature of authorised signatory —1— 14. REQUEST FOR VERIFICATION, to: 15. RESULT OF VERIFICATION Verification carried out shows that this certificate (1) □ was issued by the authorised body indicated and that the information contained therein is accurate. □ does not meet the requirements as to authenticity and accuracy (see remarks appended) Verification of the authenticity and accuracy of this certificate is requested. ...............................................……………................................. .........................................……………………………….. (Place and date) (Place and date) Stamp Stamp ...............................................……………................................ .........................................……………………………….. (Signature) (Signature) _____________________ (1) Insert X in the appropriate box. NOTES 1. Certificate must not contain erasures or words written over one another. 2. No spaces shall be left between the items entered on the certificate and each item shall be preceded by an item number. If the space of the box is not completely filled, “*” (stars) or “ \ ” (finishing slash) should be added after the description of the goods, or a horizontal line should be drawn below the last line of the description, and the empty space crossed through. 3. Goods must be described in accordance with commercial practice and with sufficient detail to enable them to be identified. 4. The number of items listed should not exceed 50. 5. This certificate should be issued in one original and two copies. 6. For each good described in box 7, state which criterion is applicable, according to the following instructions. The rules of origin are contained in Chapter 3 and Annex II. Origin Criterion Insert in Box 9 The product is “wholly obtained” in the territory of a Party, as referred to WO in Article 3.3 or the product specific rules of Annex II. The product was produced in a Party exclusively from materials originating from one or both Parties conforming to the provisions of WP Chapter 3. The product is produced in the territory of one or both Parties, using non-originating materials that conform to the Product Specific Rules and PSR other applicable provisions of Chapter 3. —2— 原产地证书（中文样本供参考） 1. 出口商 (名称，详细地址，国家） No. 000.000 中国-瑞士自由贸易区原产地证书 2. 收货人(名称，详细地址，国家） 完成此表前请阅读背页的注意事项 3. 运输细节（就所知而言） 4. 备注 离港日期 船舶/飞机/火车/运输工具编码 装货口岸 卸货口岸 5. 项目 6. 包 装 唛 7.包装数量及种类；商品 8. HS 编 码 9. 原 产 10. 毛 重 11. 发 票 号 （ 最 头及编号 描述 (6 位) 地标准 （公斤）或 （编号和日 多 50 其 他 计 量 期） 项） 单位（升， 立方米等） 12. 授权机构审核 13. 出口商申明 根据实际监管，兹证明出口商的申报正确无误。 兹申明上述填报资料及说明正确无误，所有货物 产自 ………………………………….. (国家) 上述货物符合中国-瑞士自贸区原产地规则的相关 规定。该货物出口至 …………………………………..(进口国) ……................................................................................. ................................................................................... 地点、日期、签名及授权机构印章 地点、日期、签名及授权人签名 —3— 14. 核查要求至 : 15. 核查结果 实际核查结果证明该证书(1) □确为授权机构所签发，且该证书上的相关信息 准确无误 □不符合真实性和准确性要求（见附注） 请求核查该份证书的真实性，以及证书上有关内容的 准确性。 ...............................................……………......................... .........................................…………………………… ........ ….. (地点和日期) (地点和日期) 印章 印章 ...............................................……………......................... .........................................…………………………… ....... ….. (签名) (签名) _____________________ (1) 在对应的方框内划“X”。 注意事项 1. 证书不得涂改及叠印。 2. 证书项目之间不得留空，每项内容之前必须有项目编号。商品描述完毕后应加“*”（星 号）或“\”（斜杠），或者在商品描述的下一行划横线，将剩余的空白划掉。 3. 商品描述必须符合商业实际。该描述应包含足够的细节以助于识别商品。 4. 填写项目不得超过 50 项。 5. 本证书应签发一份原件和两份复印件。 6. 若第 7 栏中货物符合原产地规则，出口商必须按照下表所示方式申明货物享受优惠待遇 所依据的原产地标准。原产地规则在第三章和附件二中予以规定。 原产地标准 填入第 9 栏 该产品是根据第 3.3 条或者附件 2 的产品特定规则的规定，在一方完 全获得； WO 该产品是在一方境内，完全由符合第三章规定的一方或双方的原产 材料生产的； WP 该产品是在一方或双方境内，使用符合第三章所规定的产品特定原 产地规则及其他要求的非原产材料生产的。 PSR —4—