IN ACCORDANCE WITH NIGERIAN GOVERNMENT NOTICE 1989 OF 1970

NIGERIA

C16

Combined Certificate of Value and Origin and Invoice of Goods forExportation to Nigeria

CERTIFICATE OF VALUE

I, .........................................................................................................................................................................

of ....................................................................................................................................................................................

*Manufacturers/Suppliers/Exporters of the goods enumerated in this invoice amounting to .........................................

.........................................................................................................................................................................................................hereby declare that I have the authority to make'and sign this certificate on behall of the aloresaid *Manufacturers/Suppliers/Exporters and that I have the means of knowing and I do hereby certify as lollows:-

(1) That this invoice is in ali respects correct and contains a true and full statement 01 the price actually paid orto be paid for the said goods, and the actual quantity thereof.

(2) That no different invoice of the goods mentioned in the said invoice has been or will be furnished to anyone.

(3) That no arrangement or understanding affecting the purchase price of the said goods has been or will bemade or entered into between the said exporter and purchaser or by anyone on behalf 01either 01 them either byway 01 discount, rebate, compensation or in any manner whatever other than as lully shown on this invoice.

CERTIFICATE OF ORIGIN

(1) That ali the goods mentioned in this invoice have been wholly produced or manulactured in .................................

........................................................................................................................................................................................

(2) That ali goods mentioned in this invoice have been either wholly or partially produced or manulactured in

........................................................................................................................................................................................

(3) That as regards those goods only partially produced or manulactured,(a) the linal process or processes 01 manulacture have been performed in ...........................................................

(b) the expenditure in material produced andlor labour performed in calculatedsubject to qualilications hereunder, in the case 01 ali such goods is not less than 25 per cent 01 the lactory or workscosts 01ali such goods in their linished state. *See note below.

(4) That in the calculation 01 such proportion 01material produced and/or labour performed none 01the lollowingitems has been included or considered:-

Manulacturer's prolit, or remuneration of any trader, agent, broker or other person dealing in the goods in theirlinished condition; royalties; cost 01outside packages, or any cost 01packing the goods thereinto; any cost 01conveying, insuring, or shipping the goods subsequent to their manulacture.

Dated at.. this.. ...day 01 ...... ....................

(Signature) ..(Signature of Witness)..................................................

Note: (1) The person making the declaration should be the principal or a manager, chiel clerk, secretary, orresponsible employee.

(2) The piace or country 01origin 01 imports is that in which the goods were produced or manulactured and,in the case 01 partly manulactured goods, the piace or country in which any linal operation, has alteredto any appreciable extent the character, composition and value 01goods imported into that country.

(3) In the case 01goods which have at some stage entered into the commerce 01,or undergone a process01 manulacture in a loreign country, only that labour and material which are expected in or added to thegoods after their return to the exporting territory shall be regarded as the produce or manulacture of theterritory in calculating the proportion of labour and material in the factory or works cost 01 thelinished article.

(4) *Delete the inapplicable

Enumerate the lollowing charges and state whether each amount has beenincluded in or excluded Irom the above selling price to purchaser:- Amount in currency 01

exporting countryState il included in aboveselling price to purchaser

(1) Cartage to rai! and/or docks

(2) Inland Ireight (rai! or canal) and other charges to the dock area, including inlandinsurance

(3) Labour in packing the goods into outside packages

(4) Value 01 outside packages

(5) Il the goods are subject to any charge by way of royalties

(6) OCEAN FREIGHT

(7) OCEAN INSURANCE ...

(8) Commission, establishment and other charges 01 a like nature ...

(9) Other costs, dues, charges and expenses incidental to the delivery of the articles

State lull particulars 01 Royalties below:-

Form No. 441 D TATEFREIGHT FORMS Waybill House, l Fitzhamon Courl, Wolverton Mill' Millon Keynes. MK12 6BA

Invoice No. ....................................................

Piace and Dale..................................................................................................................

'State heregenerai natureor class 01goods.

*1NVOICE of .supplied

by of.........................................................................................................

Io 0f.........................................................................................................

lo be shipped per : ....

Order No. ......................................................

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Counlry ofMarks and Selling Price lo Purchasernumbers on QUANTITY AND DESCRIPTION OF GOODS

Origin packages @ Amounl