Australia-India ECTA Annex 4A (Minimum Information Requirements)

Accessible text format

This list below has been taken from the official agreed text to ensure it is accessible to users who require assistive technology to access information online. The ECTA agreed text is the prescribed format included at the links above. All ECTA Certificates of Origin must be submitted in this format. Please contact ftaorigin@dfat.gov.au for more information.

1. Exporter’s Name, Address, and Country:
   • Certification No.
   • Number of pages

2. Producer’s Name, Address, and Country:

   INDIA-AUSTRALIA ECONOMIC COOPERATION AND TRADE AGREEMENT

   CERTIFICATE OF ORIGIN

3. Importer or Consignee’s Name, Address, and Country:
4. Transport details:
5. Item number (as necessary); Marks and numbers; Number and kind of packages; Description of good(s); HS Code (six-digit level)

6. ORIGIN criterion (see overleaf note)

   ☐ Cumulation (if applicable)

7. Gross Weight or other Quantity
8. Invoice number(s) and date(s)

9. Remarks: (if applicable)

   ☐ ISSUED RETROSPECTIVELY

10. Non-Party Invoicing Name, Address, and Country (if applicable)

11. Declaration by the exporter:

    I, the undersigned, declare that:

    - the above details and statement are true and accurate;

    - the good(s) described above meet the condition(s) required for the issuance of this certificate; and

    - the country of origin of the good(s) described above is:______

    Place and Date:

    Signature:

    Name (printed):

    Company:

12. Certification

    It is hereby certified, on the basis of control carried out, that the declaration by the exporter is correct.

    Export Document Number:

    Issuing Authority:

    [Stamp]

    Place and Date:

    Signature: