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1 POTRDILO O GIBANJU BLAGA / MOVEMENT CERTIFICATE 1. Izvoznik (ime, polni naslov, država) Exporter (name, full address, country) EUR. 1 št./ A Preden izpolnite obrazec, preberite navodila na hrbtni strani See notes overleaf before completing this form 2. To potrdilo se uporablja za preferencialno trgovino med Certificate used in preferential trade between 3. Prejemnik ( me, polni naslov, država) (navedba neobvezna) Consignee (name, full address, country) (Optional) in / and (navesti ustrezne države, skupine držav ali teritorije) (Insert appropriate countries, groups of countries or territories) 4. Država, skupina držav ali teritorij porekla izdelkov Country, group of countries or territory in which the products are considered as originating 5. Namembna država, skupina držav ali teritorij Country, group of countries or territory of destination 6. Podatki v zvezi s prevozom (navedba neobvezna) Transport" details (Optional) 7. Opombe Remarks 8. Zaporedna številka; oznake in številke; število in vrsta paketov" 1 ; poimenovanje blaga Item number; Marks and numbers; Number and kind of packages'"; Description of goods 9. Bruto teža (kg) ali druga merska enota (I, m 3, itd.) Gross mass (kg) or other measure (litres, m 3, etc.) 10. Računi (navedba neobvezna) Invoices (Optional) 11. CARINSKA OVEROVITEV / CUSTOMS ENDORSEMENT Overjena izjava / Declaration certified Izvozni dokument' 2 ' / Export document' 2 ': Tip / Form Št. / No Carinski urad / Customs office: Država ali ozemlje izdaje / Issuing country or territory: Pečat / Stamp 12. IZJAVA IZVOZNIKA DECLARATION BY THE EXPORTER Podpisani izjavljam, da zgoraj poimenovano blago izpolnjuje vse pogoje, potrebne za Izdajo tega potrdila. I, the undersigned, declare that the goods described above meet the conditions required for the issue of this certificate. Kraj in datum / Place and date: Kraj in datum / Place and date:. (Podpis I Signature) (Podpis / Signature)
2 13. ZAHTEVEK ZA PREVERJANJE, poslati na: REQUEST FOR VERIFICATION, to: CARINSKA UPRAVA REPUBLIKE SLOVENIJE GENERALNI CARINSKI URAD Šmartinska Ljubljana SLOVENIJA Vložen je zahtevek za preverjanje verodostojnosti in točnosti tega potrdila. Verification of the authenticity and accuracy of this certificate is requested. 14. REZULTAT PREVERJANJA RESULT OF VERIFICATION Na podlagi izvedenega preverjanja je bilo ugotovljeno, da 1) Verification carried out shows that this certificate 111 Ί je to potrdilo resnično izdal navedeni carinski urad in da so I 1 navedbe, ki jih vsebuje, točne. was issued by the customs office indicated and that the information contained therein Is accurate. i j to potrdilo ne izpolnjuje zahtevanih pogojev o verodostojnosti 1 1 in točnosti (glej priložene opombe). does not meet the requirements as to authenticity and accuracy (see remarks appended). (Kraj in datum / Place and date) (Kraj in datum / Place and date) Pečat / Stamp Pečat / Stamp (Podpis / Signature) (Podpis / Signature) (1) Označi ustrezno navedbo z Χ / Insert X in the appropriate box. OPOMBE / NOTES 1. Potrdila ne smejo vsebovati izbrisov ali ponovnih vpisov. Morebitni popravki morajo biti izvedeni tako, da se napačne navedbe prečrtajo in po potrebi dodajo pravilne. Vsako tako spremembo mora potrditi oseba, ki je potrdilo izpolnila, in jo overiti carinski organi države ali ozemlja izdaje. Certificates must not contain erasures or words written over one another. Any alterations must be made by deleting the incorrect particulars and adding any necessary corrections. Any such alteration must be initialled by the person who completed the certificate and endorsed by the customs authorities of the issuing country or territory. 2. Izdelki, navedeni v potrdilu, si morajo slediti neprekinjeno, in pred vsakim izdelkom mora biti zaporedna številka. Neposredno pod zadnjim izdelkom mora biti potegnjena vodoravna črta. Neuporabljen prostor mora biti prečrtan tako, da je dodajanje naknadnih podatkov onemogočeno. No spaces must be left between the items entered on the certificate and each item must be preceded by an item number. A horizontal line must be drawn immediately below the last item. Any unused space must be struck through in such a manner as to make any later additions impossible. 3. Blago mora biti poimenovano v skladu s trgovinskimi običaji tako natančno, da se lahko identificira. Goods must be described in accordance with commercial practice and with sufficient detail to enable them to be identified.
3 ZAHTEVEK ZA POTRDILO O GIBANJU BLAGA 1. Izvoznik (ime, polni naslov, država) EUR. 1 št. A В 6 8 Preden izpolnite obrazec, preberite navodila na hrbtni strani 3. Prejemnik (ime, polni naslov, država) (navedba neobvezna) 2. Zahtevek za potrdilo se uporablja za preferencialno trgovino med in (navesti ustrezne države, skupine držav ali teritorije) 4. Država, skupina držav ali teritorij porekla izdelkov 5. Namembna država, skupina držav ali teritorij 6. Podatki v zvezi s prevozom (navedba neobvezna) 7. Opombe 8. Zaporedna številka; oznake in številke; število in vrsta paketov 0 '; poimenovanje blaga 9. Bruto teža (kg) ali druga merska enota (I, m 3, itd.) 10. Računi (navedba neobvezna)
4 IZJAVA IZVOZNIKA Podpisani, izvoznik blaga, poimenovanega na prednji strani, IZJAVLJAM, da to blago izpolnjuje zahtevane pogoje za izdajo priloženega potrdila; NAVAJAM okoliščine, na podlagi katerih to blago izpolnjuje zahtevane pogoje: PRILAGAM naslednje dokazilne listine' 1 ': SE ZAVEZUJEM, da bom na zahtevo pristojnih organov predložil vsa dodatna dokazila, ki jih ti štejejo kot potrebna za izdajo priloženega potrdila, kot tudi pristajam, če je to potrebno, na kakršen koli pregled mojega knjigovodstva In okoliščin izdelave omenjenega blaga s strani pristojnih organov; PROSIM za izdajo priloženega potrdila za to blago. (Kraj in datum) (Podpis) (1) Na primer: uvozne listine, potrdila o gibanju, računi, izjave proizvajalca itd., ki se nanašajo na v izdelavi uporabljene izdelke ali na v enakem stanju ponovno izvoženo blago.
5 ZAHTEVEK ZA POTRDILO O GIBANJU BLAGA 1. Izvoznik ( me, polni naslov, država) EUR. 1 št. A Preden izpolnite obrazec, preberite navodila na hrbtni strani 3. Prejemnik (ime, polni naslov, država) (navedba neobvezna) 2. Zahtevek za potrdilo se uporablja za preferencialno trgovino med in (navesti ustrezne države, skupine držav ali teritorije) 4. Država, skupina držav ali teritorij porekla izdelkov 5. Namembna država, skupina držav ali teritorij 6. Podatki v zvezi s prevozom (navedba neobvezna) 7. Opombe 8. Zaporedna številka; oznake in številke; število in vrsta paketov 1 "; poimenovanje blaga 9. Bruto teža (kg) ali druga merska enota (I, m 3, itd.) 10. Računi (navedba neobvezna)
6 IZJAVA IZVOZNIKA Podpisani, izvoznik blaga, poimenovanega na prednji strani, IZJAVLJAM, da to blago izpolnjuje zahtevane pogoje za izdajo priloženega potrdila; NAVAJAM okoliščine, na podlagi katerih to blago Izpolnjuje zahtevane pogoje; PRILAGAM naslednje dokazllne listine 0 ': SE ZAVEZUJEM, da bom na zahtevo pristojnih organov predložil vsa dodatna dokazila, ki jih ti štejejo kot potrebna za izdajo priloženega potrdila, kot tudi pristajam, če je to potrebno, na kakršen koli pregled mojega knjigovodstva in okoliščin izdelave omenjenega blaga s strani pristojnih organov; PROSIM za izdajo priloženega potrdila za to blago. (Kraj in datum) (Podpis) (1) Na primer: uvozne listine, potrdila o gibanju, računi, izjave proizvajalca Itd., ki se nanašajo na v izdelavi uporabljene izdelke ali na v enakem stanju ponovno izvoženo blago.
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