Appendix 5B

United Kingdom

Supplier declaration for products not having preferential original status

I, the undersigned, declare that the goods listed on this invoice …^f1 were produced in …^f2 and incorporate the following components or materials which do not have ACP, OCT or Union origin for preferential trade:

…^f3 …^f4 …^f5

…

…^f6

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

…^f7 …^f8

…^f9

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, OCT or South Africa.

f3

Description is to be given in all cases. The description must be adequate and should be sufficiently detailed to allow the tariff classification of the goods concerned to be determined.

f4

Customs values to be given only if required.

f5

Country of origin to be given only if required. The origin to be given must be a preferential origin, all other origins to be given as ‘third country’.

f6

‘and have undergone the following processing in [the Union] [Member State] [ACP State] [OCT] [South Africa] …’, to be added with a description of the processing carried out if this information is required.

f7

Place and date.

f8

Name and function in company.

f9

Signature.