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Coo Inv 06 BHATT

This document is a Certificate of Origin for a shipment of Bangkirai sawn timber sizes from Indonesia to India. It certifies that 39,569.20 KGM of Bangkirai sawn timber worth USD 16,028.74 was shipped on May 10, 2021 from Gresik, Indonesia to Kolkata, India. The document contains details of the exporter, consignee, means of transport, origin criteria, invoice details, declarations, and certifications required for claiming preferential tariff treatment under the ASEAN-India Free Trade Area.

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292 views2 pages

Coo Inv 06 BHATT

This document is a Certificate of Origin for a shipment of Bangkirai sawn timber sizes from Indonesia to India. It certifies that 39,569.20 KGM of Bangkirai sawn timber worth USD 16,028.74 was shipped on May 10, 2021 from Gresik, Indonesia to Kolkata, India. The document contains details of the exporter, consignee, means of transport, origin criteria, invoice details, declarations, and certifications required for claiming preferential tariff treatment under the ASEAN-India Free Trade Area.

Uploaded by

Ipons Ponaryo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Original

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1 . Goods consigned from { Exportefs business name, addrBss, csJntry) RererenceNo. 0049608/SByl2O21
CV. MAROV INTERNATIONAL
JALAN TANJU}.IG'*'IRA't//32, RT,Os, RW, 1 2 ASEAN-INDIA FREE T*ADE AREA,
GKB, DS. YOSOWLANGUN,
PREFERENTIAL TARIFF
KEC. MANYAR, KAE. GRESIK 51.151,
JAWA TIMUR, INDONE$'A CERTIFICATE OF ORIGIN
TEL: +62-81230920864 {Combined Declaration and Certificate)

2. Goods consigned to {Consignee's name, address, country) FORM AI


BHATTACHARYA TIMBER lssued in INDONESIA
52, BHUPEN BOSE AVENUE (counw)
SHYAMBAZAR, KOLKATA - 7OOOO4 WEST BENGAL, INDIA
S* Not6 Ovedeal

3. Means of transport and route (as far as known) 4. For Otrcial Use
[---l Preferential Tariff Treatment Given Under
Departure Date MAY 10,2021
I I ASEANJndia Free Trade Area Preferential Tanff

Vessel's name/Aircraft etc. MAERSK YAMUNA V.1 l8N


[-_l Preferential Tariff Treatment Not Given (Please
Port of Discharge KOLKATA, INDIA
I I state reason/s)

il;;il;;
Country
;ilh.;il il;;-.,y ; th; ffi il;
5. ltem 6. Marks and 7. Number and type of packages, description of 8. Origin criterion 9. Gross weight or other 10. Numberand
number numbers on goods (include quantity where appropriate and {see Notes overleafl quantity and value (FOB) date of
Packages HS number of the importing country) lnvoices

1 2 X 20'CONTAINERS STC : 39,s69.20 KGM 06tMRV-05itNV/


31 BUNDLES = 7,'106 PCS = s9.3692 CBM usD 16,028.74 vt2021
OF BANGKIRAI SAWN SIZES & BANGKIARI E2E MAY 3. 2021
SIZES GRADE-B
HS CODE :4409.22.0O

1 1. Declaration by the exporter 12. Certification


The undersigned hereby declares that the above details and It is hereby certified, on the basis of control canied out, that the declaration
statement are correct; that all the goods were produced in by the exporter is corect.

INDONESIA ISSUED RETROACTIVELY, DATE OF SHIPMENT: MAY 10,202''


(counrry) ISSUING OFFICE IN PROVINSI JAWA TIMUR
and that they comply with the origin requirements specified for
these goods in the ASEAN-lndia Free Trade Area Preferential
Tariff for the goods exported to

(lmpofting Country)

",t,
ABDIEL POPANG KABANGA
GRESIK, MAY 18,2021 SURABAYA, MAY 18, 2021

* Place and date, signaiure ofauthorised signatory Place and date, signature and stamp of certifoing authority

13.Where appropriate please tick:

l-l fnira Country lnvoicing l-l Exhibition l--l Back-teBack CO l-l Cumulation

Fo Page

Fr'
ATTACHMENT CERTIFICATB OF ORIGIN
INVOICE NO : 06/MRV-05/INV lV 12021
DATED : MAY 03,2021

HS CODE :4409.22.00

CONSIGNEE :
BHATTACHARYA TIMBER
52, BHUPEN BOSE AVENUE
SHYAMBAZAR, KOLKATA - 7OOOO4, WEST BENGAL, INDIA
IEC NO :0209009721
GST NO : 19AAJFB2803MIZB
PAN NO: AAJFB2803M
MAIL ID : BFIASKAR.BHATTACHARYAO3 @GMAIL.COM

NOTIFY PARTY :
BHATTACHARYA TIMBER
52, BHUPEN BOSE AVENUE
SHYAMBAZAR, KOLKATA _ 7OOOO4, WEST BENGAL, INDIA
IEC NO :0209009721,
GST NO : 19 AAJFB2803M1ZB
PAN NO: AAJFB2803M
MAIL ID : BHASKAR.BHATTACHARYAO3@GMAIL.COM

CONTAINER NO. :

MSKU447 99 62 I ML-LD t2327 06


MSKU234 4823 I ML-rDt2327 05

PROVINCIAL OFFICE IN SURABAYA

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