# Regulation (EU) 2016/1076 of the European Parliament and of the Council of 8 June 2016 applying the arrangements for products originating in certain states which are part of the African, Caribbean and Pacific (ACP) Group of States provided for in agreements establishing, or leading to the establishment of, economic partnership agreements (recast), Appendix 5B

Extent: E+W+S+N.I.

Supplier declaration for products not having preferential original status
I, the undersigned, declare that the goods listed on this invoice … were produced in … and incorporate the following components or materials which do not have ACP, OCT or Union origin for preferential trade:
… … …
…
…
I undertake to make available to the customs authorities, if required, evidence in support of this declaration.
… …
…
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.

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Source: https://www.legislation.gov.uk/eur/2016/1076/annex/II/appendix/5B (the official version)
Page: https://openlegislation.uk/eu-regulation-2016-1076/annex-II/appendix-5B
Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.