¹[Annexure-E

[see sub-rule (1) of rule 15]

Format of the Certificate of Origin under the India-UAE Trade Agreement

Exporter’s Name, Address, and Country:

Certification No.

Number of page

Manufacturer’s Name,

Address, and Country:

AGREEMENT BETWEEN INDIA AND UAE

CERTIFICATE OF ORIGIN

Importer’s or Consignee’s

Name, Address, and Country:

Transport details

Item number (as necessary); Marks and numbers; Number and kind of packages; Description of good(s); HS tariff classification number

6. ORIGIN

criterion (see overleaf note)

Cumulation

7. Gross Weight or other Quantity

8. Invoice number(s) and date(s)

Remarks:

SUED RETROSPECTIVELY

10. Third-Party Invoicing Name, Address, and Country

11. Declaration by the exporter:

I, the undersigned, declare that:

12. Certification

It is hereby certified, on the basis of control carried out, that the declaration by the exporter is correct.

the above details and statement are true and accurate;
the good(s) described above meet the condition(s) required for the issuance of this certificate; and
the country of origin of the good(s) described above is:______ Place and Date:

Signature:

Name (printed):

Company:

Export Document Number:

Issuing Authority:

[Stamp]

Place and Date:

Signature:

Overleaf Notes:

The following origin criteria code should be inserted in Box 5:

[F.No. 15020/4/2021-ICD(CBEC)]

(Komila Punia)

Deputy Secretary to the Government of India]

Notes:

1[Annexure-E