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MV. TIAN HE - Final Draft COO Rev1

1. This document is a Certificate of Origin for a shipment of 42,200 metric tons of Indonesian steam coal in bulk from PT. Artha Tunggal Mandiri in Indonesia to Xiamen Xiangyu Logistics Group Corporation in China. 2. The coal will be transported by vessel MV. Tian He, departing on August 29th, 2022 from Indonesia and discharging at Yangzhou Port in China. 3. The certificate is issued by the issuing office in Kabupaten Berau, Indonesia to certify that the coal meets the origin criteria to receive preferential tariff treatment under the ASEAN-China Free Trade Area agreement.

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62 views1 page

MV. TIAN HE - Final Draft COO Rev1

1. This document is a Certificate of Origin for a shipment of 42,200 metric tons of Indonesian steam coal in bulk from PT. Artha Tunggal Mandiri in Indonesia to Xiamen Xiangyu Logistics Group Corporation in China. 2. The coal will be transported by vessel MV. Tian He, departing on August 29th, 2022 from Indonesia and discharging at Yangzhou Port in China. 3. The certificate is issued by the issuing office in Kabupaten Berau, Indonesia to certify that the coal meets the origin criteria to receive preferential tariff treatment under the ASEAN-China Free Trade Area agreement.

Uploaded by

Haute Fit
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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1. Products consigned from (Exporter's business name, address, country) Reference No.

PT. ARTHA TUNGGAL MANDIRI


JL. PULAU DERAWAN RT. 31, TANJUNG REDEB, BERAU, ASEAN-CHINA FREE TRADE AREA
KALIMANTAN TIMUR, 77311 - INDONESIA PREFERENTIAL TARIFF
CERTIFICATE OF ORIGIN
(Combined Declaration and Certificate)
2. Products consigned to (Consignee's name, address, country)
FORM E
XIAMEN XIANGYU LOGISTICS GROUP CORPORATION
2 UNITS, 9/F, TOWER E XIAMEN INTERNATIONAL SHIPPING CENTER,
99 XIANGYU ROAD, MODERN LOGISTICS PARK, Issued in INDONESIA
XIAMEN CITY, FUJIAN PROVINCE P.R. CHINA

See Overleaf Notes

3. Means of transport and route (as far as known) 4. For Official use

Departure Date AUGUST 29, 2022 Preferential Treatment Given

Vessel's name/Aircraft etc. MV. TIAN HE Preferential Treatment Not Given (Please state reason/s)

.................................................................................................................
Port of Discharge YANGZHOU PORT, CHINA
Signature of Authorised Signatory of the Importing Party

5. Item 6. Marks and 7. Number and type of packages, 8. Origin criteria 9. Gross weight 10. Number,
number numbers of description of products (including (see Overleaf or net weight or date of invoices
packages quantity where appropriate and Notes) other quantity and
HS number in six digit code) value (FOB) only
when RVC
criterion is applied

1 NO MARK IN BULK (LIGNITE) INDONESIAN STEAM COAL IN WO 42,200 TNE C82A-2022-XIII


BULK (FORTY-TWO AUGUST 29, 2022
THOUSAND TWO
HS: 270210 HUNDRED)

11. Declaration by the exporter 12. Certification


The undersigned hereby declares that the above details and statement are It is hereby certified, on the basis of control carried out, that the declaration by
correct; that all the products were produced in the exporter is correct

INDONESIA ISSUING OFFICE IN KABUPATEN BERAU


.....................................................................
(Country)

and that they comply with the origin requirements specified for these
products in the Rules of Origin for the ACFTA for the products exported to

CHINA
.....................................................................
(Importing Country)

TANJUNG REDEB,
..........................................................................................................
Place and date, signature of authorised signatory

13.
v
Issued Retroactively Exhibition ,
.............................................................................................................
Movement Certificate Third Party Invoicing Place and date, signature and stamp of certifying authority

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