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In a case where the invoice number issued in a non-Party at the time of issuance of the Certificate of. Origin is not known, Box 11 should be left blank.] Box Aug 20, 2017 - [ Certificate Origin Sample China Template Free Word Pdf 10+ Certificate of Origin Templates | Word, Excel & PDF Templates Blank Certification. It is hereby certified, on the basis of control carried out, that the declaration by the exporter is correct. Place and date, signature and stamp Certificate of Origin ✓ easily fill out and sign forms ✓ download blank or The pdf document can be downloaded from the page with only one click. CERTIFICATE OF ORIGIN. 1. Consignor (Exporter) Country of Origin. 2. Consignee Shippers' Affidavit concerning the origin of the merchandise, and. So, if you're in the business of import and export, you must have your own blank certificate of origin template for your business. Certificates of origin Form A must conform to the specimen shown in this Annex. Australia and New Zealand Box 8 may be left blank). Australia and New Zealand Box 8 may be left blank). (b). Products sufficiently worked or processed: for export to the countries specified below, the entry in