原產地證書是證明貨物的生產或制造地的文件，簡稱原產地證，原產地證書在國際貿易中往往被進口國用來作為實行區(qū)別關稅待遇和實施國別貿易政策管理的重要依據(jù)，例如最惠國待遇、政府采購、保障措施的正確實施等等，因此具有待定的法律效力和經(jīng)濟作用。下面是一則特別優(yōu)惠關稅待遇的原產地證明書，供大家參考。
老柬緬特別優(yōu)惠關稅待遇（SPT）原產地證書
1. Goods consigned from (Exporter's business name, address, Reference No.
country)
SPECIAL AND PREFERENTIAL TARIFF TREATMENT FOR CLM
CERTIFICATE OF ORIGIN
(Combined Declaration and Certificate)
2. Goods consigned to (Consignee's name, address, country) FORM SPT
Issued in ……………………………...………………………………
(Country)
See Notes Overleaf
3. Means of transport and route (as far as known) 4. For Official Use
Departure date Special and Preferential Tariff Treatment granted by the People's
Republic of China to CLM
Vessel's name/Aircraft etc.
Port of Discharge …………………………………………………..…....………………
Signature of Authorised Signatory of China
5. Item 6. Marks and 7. Number and type of packages, description of goods 8. Origin 9. Gross 10. Number and
number numbers of (including quantity where appropriate and HS number Criterion (See weight or other date of
packages of China Overleaf quantity and invoices
Note) value FOB)
11. Declaration by the exporter 12. Certification
The undersigned hereby declares that the above details and It is hereby certified, on the basis of control carried out, that the
statement are correct; that all the goods were produced in declaration by the exporter is correct.
……………………………..…..……….………………..……….
(Country)
and that they comply with the origin requirements specified for
these goods in the Special and Preferential Tariff Treatment for
the goods exported to China
……………………………….…...……………….……………… …………………………………………………………………………
Place and date, signature of authorised signatory Place and date, signature and stamp of certifying authority
老柬緬特別優(yōu)惠關稅待遇（SPT）原產地證書
1. Goods consigned from (Exporter's business name, address, Reference No.
country)
SPECIAL AND PREFERENTIAL TARIFF TREATMENT FOR CLM
CERTIFICATE OF ORIGIN
(Combined Declaration and Certificate)
2. Goods consigned to (Consignee's name, address, country) FORM SPT
Issued in ……………………………...………………………………
(Country)
See Notes Overleaf
3. Means of transport and route (as far as known) 4. For Official Use
Departure date Special and Preferential Tariff Treatment granted by the People's
Republic of China to CLM
Vessel's name/Aircraft etc.
Port of Discharge …………………………………………………..…....………………
Signature of Authorised Signatory of China
5. Item 6. Marks and 7. Number and type of packages, description of goods 8. Origin 9. Gross 10. Number and
number numbers of (including quantity where appropriate and HS number Criterion (See weight or other date of
packages of China Overleaf quantity and invoices
Note) value FOB)
11. Declaration by the exporter 12. Certification
The undersigned hereby declares that the above details and It is hereby certified, on the basis of control carried out, that the
statement are correct; that all the goods were produced in declaration by the exporter is correct.
……………………………..…..……….………………..……….
(Country)
and that they comply with the origin requirements specified for
these goods in the Special and Preferential Tariff Treatment for
the goods exported to China
……………………………….…...……………….……………… …………………………………………………………………………
Place and date, signature of authorised signatory Place and date, signature and stamp of certifying authority