附表1(一般產證)

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(1)附表 1(一般產證) dfs. 1.出口人名稱及地址 Exporter’s Name and Address CERTIFICATE NO. Page. of. CERTIFICATE OF ORIGIN (Issued in Taiwan) 2.進口人名稱及地址 Importer’s Name and Address. APPLICATION. 申請書 4. 卸貨港 Port of Discharge. 3. 裝貨港 Port of Loading. 5. 目的地國 Country of Destination. 6. 貨品明細含名稱、型號、規格、包裝標誌及編號 Description of Goods; Packaging Marks and Numbers. 7.數量/單位 Quantity/Unit. 本證不得塗改，其經塗改者，無效。This certificate shall be considered null and void in case of any alteration. 申請人（出口人）切結：The exporter hereby declares that： 8.生產廠商名稱及地址 Producer’s Name and Address 1.本證明書內所列之貨品原產地為臺灣。 The goods listed in this certificate originate in Taiwan. 2.本證明書內所列之貨品符合下列原產地認定標準： □①我國完全取得 The goods are obtained completely in Taiwan. □②我國完全生產 The goods are produced entirely in Taiwan. 貨品之加工製造涉及我國與其他國家或地區共同參與者，以在我國境內產生最終實質轉型者為限：茲證明本證明書內所列之貨品原產地為臺灣，本證明書將建檔 The goods that use non-originating materials conform to the following rules: 保存三年。 □③貨品經加工或製造後稅則前 6 位碼改變 The non-originating materials used It is hereby certified that the goods described in this certificate in the production of the goods shall undergo a change of Tariff Subheading, originate in Taiwan, and that this certificate shall be retained and filed CTSH. for three (3) years. □④貨品經加工或製造後未造成稅則前 6 位碼改變，但附加價值率超過 35% The non-originating materials used in production have not undergone a change of Tariff Subheading, but the Value Added Rate exceeds 35%. □⑤貨品經加工或製造後未造成稅則前 6 位碼改變，但符合貿易局公告之重要製程者 The non-originating materials used in production have not undergone a change of Tariff Subheading, but the processing operations specified by the BOFT have been conducted in Taiwan. 3.上述內容均已據實填報，並遵守「原產地證明書及加工證明書管理辦法」之規定，如有不實或有違法情事，願依貿易法第 28 條規定接受行政處罰。 This certificate is truthfully filled out in compliance with the “Regulations Authorized signature Governing Certificates of Origin and Certificates of Processing”. Any false statement made in this document or violation of the relevant laws is subject to administrative penalty in accordance with Article 28 of the “Foreign Trade Act”. 申請人（出口人）統一編號 Applicant’s Business Account Number:. 申請人（出口人）名稱、地址 Applicant’s Name and Address:. Stamp of exporter.

(2) COMMODITY DESCRIPTION SUPPLEMENT. CERTIFICATE NO.. 申請書. 6. Description of Goods; Packaging Marks and Numbers. This certificate shall be considered null and void in case of any alteration.. Page. of. 7. Quantity/Unit.

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