Division MOVEMENT CERTIFICATE
| 1. Exporter (Name, full address, country) | EUR.1 No A 000.000 | ||
| See notes overleaf before completing this form. | |||
| 2. Certificate used in preferential trade between | |||
| 3. Consignee (Name, full address, country) (Optional) | and | ||
| (Insert appropriate countries, groups of countries or territories) | |||
| 4. Country, group of countries or territory in which the products are considered as originating | 5. Country, group of countries or territory of destination | ||
| 6. Transport details (Optional) | 7. Remarks | ||
| 8. Item number; Marks and numbers; Number and kind of packages (1); Description of goods | 9. Gross mass (kg) or other measure (litres, m3, etc.) | 10. Invoices (Optional) | |
| 11. CUSTOMS ENDORSEMENT | 12. DECLARATION BY THE EXPORTER I, the undersigned, declare that the goods described above meet the conditions required for the issue of this certificate. | ||
| Declaration certified | |||
| Export document (2) | |||
| Form … No … | |||
| Customs office … | |||
| Issuing country or territory | |||
| Date … | Stamp | Place and date … | |
| (Signature) | (Signature) | ||
(1) If goods are not packed, indicate number of items or state “in bulk” as appropriate.
(2) Complete only where the regulations of the exporting country or territory require.
| 13. Request for verification, to: | 14. Result of verification |
| Verification carried out shows that this certificate (*) □ was issued by the customs office indicated and that the information contained therein is accurate. □ does not meet the requirements as to authenticity and accuracy (see remarks appended). | |
| Verification of the authenticity and accuracy of this certificate is requested … (Place and date) … Stamp … (Signature) | … (Place and date) … Stamp … (Signature) ________________________ (*) Insert X in the appropriate box. |