| Certificate Number | Certificate Date | ||
| Exporter Information | Producer Information | ||
| Exporter Name | Producer Name | ||
| Exporter Address | Producer Address | ||
| Importer Information | Country Of Origin And Accumulation | ||
| Importer Name | Country Name | ||
| Importer Address | Accumulation | ||
| Shipment Information | Notes | ||
| Type Of Shipment | Description | ||
| Description of Products | Weight And Invoice Information | ||
|
|
Weight |
Net Weight :
Real Weight : |
|
| Invoice |
Invoice Number :
Invoice Date : |
||