APPLICATION FOR SPECIAL GOODS EXPORT PERMIT FOR ENTERPRISES IN FREE TRADE ZONES
第 1 聯：經濟部存查聯 共 頁 第 頁
1 申請人 Applicant 2 買主 Buyer
3 收貨人 Consignee
4 目的地國別 Country of Destination 輸出許可號碼 Export Permit No.
核准日期 Issue Date 有效日期 Expiration Date 5 轉口港 Transhipment port
核准機構簽章 Approving Agency Signature/Stamp 6 檢附文件字號 Required Document Ref. No.
簽證機構加註有關規定 Special Conditions
7 項目 Item
8 貨品名稱、規格等
Description of Commodities, etc.
9 貨品分類號列及檢 查號碼 C.C.C. Code
10 數量及單位 Quantity & Unit
11 金額及條件
Monetary Value & Terms
自由貿易港區事業輸往國外特定貨品輸出許可申請書續頁
APPLICATION FOR SPECIAL GOODS EXPORT PERMIT FOR ENTERPRISES IN FREE TRADE ZONES
第 1 聯：經濟部存查聯 共 頁 第 頁
輸出許可號碼 Export Permit No.
7 項目 Item
8 貨品名稱、規格等
Description of Commodities, etc.
9 貨品分類號列及檢 查號碼 C.C.C. Code
10 數量及單位 Quantity & Unit
11 金額及條件
Monetary Value & Terms
SPECIAL GOODS EXPORT PERMIT FOR ENTERPRISES IN FREE TRADE ZONES
第 2 聯：申請人報關用聯 共 頁 第 頁
1 申請人 Applicant 2 買主 Buyer
3 收貨人 Consignee
4 目的地國別 Country of Destination 輸出許可號碼 Export Permit No.
核准日期 Issue Date 有效日期 Expiration Date 5 轉口港 Transhipment port
核准機構簽章 Approving Agency Signature/Stamp 6 檢附文件字號 Required Document Ref. No.
簽證機構加註有關規定 Special Conditions
7 項目 Item
8 貨品名稱、規格等
Description of Commodities, etc.
9 貨品分類號列及檢 查號碼 C.C.C. Code
10 數量及單位 Quantity & Unit
11 金額及條件
Monetary Value & Terms
自由貿易港區事業輸往國外特定貨品輸出許可續頁
SPECIAL GOODS EXPORT PERMIT FOR ENTERPRISES IN FREE TRADE ZONES
第 2 聯：申請人報關用聯 共 頁 第 頁
輸出許可號碼 Export Permit No.
7 項目 Item
8 貨品名稱、規格等
Description of Commodities, etc.
9 貨品分類號列及檢 查號碼 C.C.C. Code
10 數量及單位 Quantity & Unit
11 金額及條件
Monetary Value & Terms
Instructions for Filling Out Application for “Special Goods Export Permit for
Enterprises in Free Trade Zones”
欄位
Column
欄位名稱 Column Heading 填寫說明 Instructions
１
申請人 Applicant 1. 請依序填列申請人（出口人）中英文名稱、中英文地址、電話
號碼及統一編號（或身份證號或護照號碼）。
Fill in in sequence the name of the applicant (exporter) in Chinese and English, the address in Chinese and English, the phone number, and the business registration number.
2. 輸出許可證出口人名稱不得申請修改，但經貿易局專案核准者 不在此限。
The exporter’s name on the Export Permit shall not be altered unless approved by the BOFT.
２
買主 Buyer 1 請填列國外買主公司名稱及國家，可免填地址。
Fill in the name of the foreign buyer’s company and country (address is not necessary).
2. 右上角框請填列國別代碼（請參照財政部編撰之「通關作業及 統計代碼」手冊）。
Fill in the country code in the upper right corner of the box (refer to the
“Customs Clearance Operations and Statistical Codes” handbook of the Ministry of Finance).
３
收貨人 Consignee 請填列國外收貨人英文名稱及國家，右上角框填列國別代碼，如國
外收貨人與買主相同，則收貨人欄免填列。
Fill in the name and country of the foreign consignee in English. Fill in the country code in the upper right corner of the box. If the foreign consignee and buyer are the same, it is not necessary to fill in the column for consignee.
４
目 的 地 國 別 Country of Destination
係填貨物到達之目的地國家，免填目的地港口，右上角框填列國別 代碼（請參照財政部編撰之「通關作業及統計代碼」手冊）。
Fill in the country of destination for the goods (it is not necessary to fill in the port of destination). Fill in the country code in the upper right corner of the box (refer to the
“Customs Clearance Operations and Statistical Codes” handbook of the Ministry of Finance).
５
轉口港 Transhipment port 運輸方式有轉口港者，請填列此欄及右上角框代碼（請依據財政部
編撰之「通關作業及統計代碼」手冊內規定之代碼填列），無則免 填。對於限以間接貿易方式出口之地區，則應確實載明轉口港。
For goods in transit, fill in the means of transport in this column and the code in the upper right corner of the box (refer to the “Customs Clearance Operations and Statistical Codes” handbook of the Ministry of Finance for domestic regulation
codes). If there is no code, leave it blank. As for destinations restricted to exporting through indirect trade, the export of transit should be clearly indicated .
６
檢 附 文 件 字 號 Required Document Ref. No.
1. 應填列貨品來源報單號碼，例如 F1 進口報單號碼等，並檢附 報單影本。
Fill in the commodity’s origin declaration number (e.g., import declaration number F1) and attach a photocopy of the declaration.
2. 出口貨品超過 1 項以上時，來源報單號碼不同者，請填註證號 所屬項次。
If goods for export exceed 1 item and the origin declaration numbers are different, fill in the certificate numbers accordingly item-by-item.
７
項目 Item 出口貨品超過 1 項以上時，不論 C.C.C. CODE 是否相同，均應於
項次欄下冠以 1,2,3,…並與所列 C.C.C. CODE 及貨品名稱對齊。
If goods for export exceed 1 item and regardless the C.C.C. Codes are the same or not, the items in the column shall be labeled 1,2,3 and so on in alignment with the C.C.C. Codes and commodity names.
８
貨 品 名 稱 、 規 格 等
Description of Commodities, etc.
1. 貨品名稱應繕打英文為原則。
In principle, the name of the commodity should be given in English.
2. 應逐項載明該項貨品之「原生產國別(Country of Origin)」。
Each commodity shall clearly indicate its “Country of Origin.”
９
貨品分類號列及檢查號碼
C.C.C. Code
貨品分類號列（C.C.C. CODE）為 11 位碼，請查閱「中華民國進 出口貨品分類表」填列。
Fill in the 11-digit C.C.C. Code by referring to the “ROC Classifications for Imported and Exported Commodities.”
１０
數量及單位 Quantity & Unit 請依據現行進出口貨品分類表內該項貨品所載之「單位」填列，如 實際交易之數量單位與該數量單位不同時，則於實際交易數量單位 下以括弧加註經換算之數量單位。
Fill in the “units” of the goods based on the existing classifications for imported and exported commodities. If the actual number of units of transactions is different from this number of units, then the number of units can be converted and indicated in brackets beneath the actual number of units of transactions.
１１
金額及條件 Monetary Value
& Terms
1. 條件係指交貨條件諸如 FOB、C&F、CIF 等。
Terms refer to delivery such as FOB, C&F, CIF, etc.
2. 金額係填列出口貨品之單項價格及所有貨品之總價。
Fill in the price of each exported commodity and the total price of all the goods.
3. 出口貨品得以新臺幣計價，惟國外支付貨款仍應以等值之外幣 為之，輸出許可證載明外幣，新臺幣部分以括弧加註。
Denominate exported goods in NTD, but foreign payment should be made in the equivalent foreign currency and clearly indicated on the Export Permit with the NTD portion indicated in brackets.
4. 不需填列大寫金額。
It is not necessary to fill in monetary amounts using “anti-fraud numerals”.
一、本輸出許可證自發證日起 30 天內有效，但簽證機構另有規定者，從其規定。
This Export Permit is valid for 30 days from the date of issue unless otherwise specified by the certifying authority.
二、本輸出許可證應 1 次套訂，一經塗改即屬失效，貨品分類號列蓋有簽證機構校對章者除外。
One Export Permit shall be issued at a time and any alteration renders it invalid unless the C.C.C. Code bears the stamp of the certifying authority as proof.
三、本輸出許可證記有貿易資料，關係商業機密，請予保密，不得外漏或買賣。
This Export Permit contains trade data related to business secrets and confidentiality which shall not be divulged or sold.
四、如 7~11 欄不夠填寫，請以續頁填寫，續頁上端請註明共幾頁及第幾頁，並分別加附於各聯之後。
If the space given in columns 7-11 is insufficient to fill in the necessary information, continue filling in on an additional page.
Indicate the total number of pages and the page number at the top of the additional pages and attach them on the back.
五、本申請書計 2 聯（第 1 聯：經濟部存查聯；第 2 聯：申請人報關用聯）。
This application will be in duplicate (the original to be filed with the MOEA and the duplicate to be retained by the applicant).
