Sample Le Duong internal form
LE DUONGCASHEW

SAMPLE — NOT ISSUED

Related certificate service: Certificate of Origin Form A / B

Origin Information Statement (Form A / B Reference) — Le Duong Internal Form

Order and product information

Form reference
Completed after order review
Issue date
Completed after order review
Buyer / consignee
Completed after order review
Contract / PI reference
Completed after order review
Product / grade
Completed after order review
Lot / batch
Completed after order review
Quantity
Completed after order review
Country of origin
Completed after order review

Service-specific information

Exporter
Completed after order review
Consignee
Completed after order review
Means of transport and route
Completed after order review
Marks and package numbers
Completed after order review
Package count and type
Completed after order review
Goods description
Completed after order review
Origin criterion
Completed after order review
Gross weight / quantity
Completed after order review
Invoice number and date
Completed after order review
Le Duong origin declaration
Completed after order review

Review and release

Prepared by
Completed after order review
Reviewed by
Completed after order review
Approved by
Completed after order review
Release status
Completed after order review