Appendix 5A

United Kingdom

Supplier declaration for products having preferential origin status

I, the undersigned, declare that the goods listed on this invoice …^f1

were produced in …^f2 and satisfy the rules of origin governing preferential trade between the ACP States and the European Union.

I undertake to make available to the customs authorities, if required, evidence in support of this declaration.

…^f3 …^f4

…^f5

Note

The abovementioned text, suitably completed in conformity with the footnotes below, constitutes a supplier's declaration. The footnotes do not have to be reproduced.

Annotations

Footnotes

f1

If only some of the goods listed on the invoice are concerned they should be clearly indicated or marked and this marking entered on the declaration as follows: ‘ …listed on this invoice and marked …were produced …’.

If a document other than an invoice or an annex to the invoice is used (see Article 26(3)), the name of the document concerned shall be mentioned instead of …the word ‘invoice’.

f2

The Union, Member State, ACP State or OCT. Where an ACP State or an OCT is given, a reference must also be made to the Union customs office holding any relevant movement certificate(s) EUR.1, giving the reference number(s) of the certificate(s) concerned and, if possible, the relevant customs entry number.

f3

Place and date.

f4

Name and function in company.

f5

Signature.