Attachment

United Kingdom

ANNEX VII TO PROTOCOL No. 1

FORM FOR APPLICATION FOR A DEROGATION

NOTES
1. If the boxes in the form are too small for the relevant information, you may attach additional pages to the form. In this case, you should indicate “see annex” in the box concerned.
2. If possible, samples or other illustrative material (pictures, designs, catalogues, etc.) of the final product and of the materials should accompany the form.
3. You must complete a form for each product covered by the request.
Boxes 3, 4, 5, 7: “third country” means any country which is not referred to in Article 7 of the Protocol.
Box 12: If third country materials have been worked or processed in the countries or territories referred to in Article 7 of the Protocol without obtaining origin before being further processed in Ghana requesting the derogation, you should indicate the working or processing carried out in the countries or territories referred to in Article 7 of the Protocol.
Box 13: The dates to be indicated are the initial and final one for the period in which movement certificates EUR.1 may be issued under the derogation.
Box 18: Indicate either the percentage of added value in respect of the ex‐works price of the product, or the monetary amount of the added value per unit of product.
Box 19: If alternative sources of material exist, indicate here what they are and, if possible, the reasons of cost or other reasons why they are not used.
Box 20: Indicate possible further investments or suppliers’ differentiation which make the derogation necessary for only a limited period of time.
1. Commercial description of the finished product 1.1. Customs classification (HS code)	2. Anticipated annual quantity of exports to the European Union (weight, number of pieces, metres or other unit)
3. Commercial description of third country materials Customs classification (HS code)	4. Anticipated annual quantity of third country materials to be used
5. Value of third country materials	6. Ex‐works value of finished product
7. Origin of third country materials	8. Reasons why the rule of origin for the finished product cannot be satisfied
9. Commercial description of materials originating in countries or territories referred to in Article 7	10. Anticipated annual quantity of materials originating in countries or territories referred to in Article 7 to be used
11. Value of materials originating in countries or territories referred to in Article 7	12. Working or processing carried out in countries or territories referred to in Article 7 without obtaining origin
13. Duration requested for derogation from … to …	14. Detailed description of working and processing in Ghana
15. Capital structure of the firm(s) concerned	16. Amount of investments made/planned
17. Staff employed/expected	18. Value added by the working or processing in Ghana: 18.1. Labour: 18.2. Overheads: 18.3. Other:
19. Other possible sources of supply for materials	20. Possible development to overcome the need for a derogation
21. Remarks