1. Pošiljalac (ime, adresa, država)
Consignor (name, adress, country) |
Broj
Issuing number |ORIGINAL
ORIGINAL | | REPUBLIKA SRBIJAREPUBLIC OF SERBIA 2. Primalac (ime, adresa, država) Consignee (name, adress, country) UVERENjE O POREKLU ROBECERTIFICATE OF ORIGIN 3. Zemlja porekla Country of Origin 4. Podaci o transportu Transport details 5. Primedbe Remarks 6. Redni broj pošiljke; oznake; broj i vrsta paketa; opis robe Item number; marks, number and kind of packages; description of goods 7. Količina Quantity 8. PRIVREDNA KOMORA SRBIJE POTVRĐUJE DA JE NAVEDENA ROBA POREKLOM IZ DRŽAVE NAVEDENE U RUBRICI 3. SERBIAN CHAMBER OF COMMERCE HEREBY CERTIFIES THAT THE GOODS DESCRIBED ABOVE ORIGINATE IN THE COUNTRY SHOWN IN BOX 3Mesto i datum izdavanja, ime, potpis i pečat nadležnog organaPlace and date of issue, name, signature and stamp of the competent authority 1. Pošiljalac (ime, adresa, država) Consignor (name, adress, country) Broj Issuing number KOPIJACOPY REPUBLIKA SRBIJAREPUBLIC OF SERBIA 2. Primalac (ime, adresa, država) Consignee (name, adress, country) UVERENjE O POREKLU ROBECERTIFICATE OF ORIGIN 3. Zemlja porekla Country of Origin 4. Podaci o transportu Transport details 5. Primedbe Remarks 6. Redni broj pošiljke; oznake; broj i vrsta paketa; opis robe Item number; marks, number and kind of packages; description of goods 7. Količina Quantity 8. PRIVREDNA KOMORA SRBIJE POTVRĐUJE DA JE NAVEDENA ROBA POREKLOM IZ DRŽAVE NAVEDENE U RUBRICI 3. SERBIAN CHAMBER OF COMMERCE HEREBY CERTIFIES THAT THE GOODS DESCRIBED ABOVE ORIGINATE IN THE COUNTRY SHOWN IN BOX 3Mesto i datum izdavanja, ime, potpis i pečat nadležnog organaPlace and date of issue, name, signature and stamp of the competent authority
1. Pošiljalac (ime, adresa, država) Consignor (name, adress, country) Broj uverenjaIssuing number ZAHTEVAPPLICATION REPUBLIKA SRBIJAREPUBLIC OF SERBIA 2. Primalac (ime, adresa, država) Consignee (name, adress, country) UVERENjE O POREKLU ROBECERTIFICATE OF ORIGIN 3. Zemlja porekla Country of Origin 4. Podaci o transportu Transport details 5. Primedbe Remarks 6. Redni broj pošiljke; oznake; broj i vrsta paketa; opis robe Item number; marks, number and kind of packages; description of goods 7. Količina Quantity 8 Ja, dole potpisani, I, the undersigned, PODNOSIM APPLY Zahtev za izdavanje Uverenja o poreklu robe iz ______________________ (upisuje se zemlja porekla) za robu iz tarifne oznake __________________ sa naimenovanjem ___________________________ Carinske tarife. Request for issuing certificate of origin for the goods originated in _____________________ (country of origin), classified in tariff line/s ___________________, with description _______________________ of the Customs tariff. IZJAVLjUJEMDECLAREPod punom krivičnom i materijalnom odgovornošću da je roba iz tarifne oznake __________________ sa naimenovanjem _____________________________ Carinske tarife, proizveden/a u ____________________ (upisuje se zemlja porekla) za šta prilažem izjavu proizvođača (ukoliko izvoznik i proizvođač nisu isto pravno lice) ili uverenje o poreklu robe izdato od nadležnog organa države porekla, kao i ostalu dokumentaciju zahtevanu od Privredne komore Srbije. Under full criminal and substantial liability that the goods from tariff line/s________________________, with description _________________________________ of the Customs tariff, are manufactured in ______________________ (country of origin). I submit manufacturer declaration (in case where the exporter and manufacturer are not the same legal person) or certificate of origin issued by competent authority of the country of origin, as well as other documents upon request of Serbian Chamber of Commerce. OBAVEZUJEM SEUNDERTAKEObavezujem se da na zahtev Privredne komore Srbije podnesem svaki dodatni dokazni dokument koji Privredna komora Srbije smatra potrebnim radi izdavanja uverenja o poreklu robe.Upon request of Serbian Chamber of Commerce I will submit any additional document which Serbian Chamber of Commerce conceive to be needed for the purpose of issuing certificate of origin. 9. Podnosilac zahteva Applicant Mesto i datum Potpis podnosioca zahtevaPlace and date Signature of the applicant(1) (1) Potpis podnosioca zahteva mora slediti posle njegovog imena napisanog velikim slovimaThe signature of an applicant must be followed by his name in block capitals
(Dodatni prostor)(Additional space) PRAVILA ZA POPUNjAVANjE UVERENjA O POREKLU I ZAHTEVA ZA IZDAVANjE TOG UVERENjARULES TO BE OBSERVED WHEN COMPLETING A CERTIFICATE OF ORIGIN AND THE APPLICATION FOR SUCH CERTIFICATE1. Obrazac se popunjava računarom (pisaćom mašinom) ili u rukopisu, na identičan način, na srpskom ili engleskom jeziku, u zavisnosti od prakse i zahteva trgovine. Kada se obrazac popunjava u rukopisu, mora biti popunjen mastilom ili hemijskom olovkom velikim štampanim slovima.The forms shall be completed in typescript or by hand, in an identical manner, in Serbian or English language, depending on the practice and requirements of trade. When forms are completed by hand, this shall be done in ink and in block capitals.2. Obrazac i zahtev ne sme da sadrži greške ili ispravke. Izmene se vrše precrtavanjem pogrešnih podataka i dodavanjem ispravnih podataka, ako je to potrebno. Svaka izmena mora overena pečatom Privredne komore Srbije.The certificate and the application must not contain erasures or superimposed corrections. Alterations are to be made by crossing out the erroneous entries and adding the correct entries as required. Any such alteration must be endorsed by stamp of the Serbian Chamber of Commerce.3. Ispred svake stavke navedene u zahtevu i obrascu mora biti naznačen redni broj pošiljke. Horizontalna linija mora biti odmah iscrtana ispod poslednjeg unosa. Linije moraju biti iscrtane preko neiskorišćenog prostora da bi se sprečilo unošenje dodatnih podataka.Each item listed in the application on and on the certificate must be preceded by an item number. A horizontal line must be drawn immediately below the final entry. Lines must be drawn through unused spaces to make any subsequent addition impossible.4. U rubriku 2. obrasca i zahteva: „ Primalac“, može se upisati: „po naredbi“ ili se može upisati naziv države u koju se roba upućuje (krajnje odredište). Popunjavanje ove rubrike nije obavezno.Popunjavanje rubrike 4. obrasca i zahteva: „Podaci o transportu“ nije obavezno.U rubriku 5. obrasca i zahteva: „Primedbe“, mogu se navesti brojevi i datumi faktura koje se odnose na robu za koju se traži izdavanje uverenja o poreklu robe. Ukoliko se podnosi zahtev za izdavanje Uverenja o poreklu za robu koja se izvozi nakon postupka aktivnog oplemenjivanja, u rubriku 5. obrasca i zahteva, upisuje se da je na robi za koju se traži i izdaje uverenje, izvršen postupak aktivnog oplemenjivanja u Republici Srbiji, a može se upisati i stepen izvršenog aktivnog oplemenjivanja. In Box 2. of certificate and application: „Consignee”, may be write in: „to order“ or name of country of final destination of goods. Filling of this box is not obligatory. Filling of box 4. of certificate and application: „Transport details”, is not obligatory. In box 5. of certificate and application: „Remarks”, may be specified numbers and dates of invoices related to goods subject of request for issuing of Certificate of origin. In case of request for issuing certificate of origin for the goods which is to be exported after inward-processing procedure, in the box 5. of certificate and request, is to be written that the above mentioned procedure was done in the Republic of Serbia; the level of inward- processing carried out in Republic of Serbia may be written too.4. Ako potrebe trgovine to zahtevaju, jedna ili više dodatnih kopija uverenja o domaćem poreklu može biti napravljena.If the needs of export trade so require, one or more extra copies of the certificate may be made.