TWENTY‑FIRST SCHEDULE
Paragraph 4(5)(v)
DECLARATION OF ORIGIN
Agreement between Singapore and the Separate Customs Territory
of Taiwan, Penghu, Kinmen and Matsu (“Chinese Taipei”)
on Economic Partnership (“ASTEP”)
1.   Name of Exporter:
 
Address:
 
 
2.   Name of Consignee:
 
Address:
 
 
3.   Producer name: (Optional field & to be filled only if known)
 
 
 
4.   Description of Goods
5.   HS Tariff Classification
6.   Number & Date of Invoice
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
7.   I hereby declare that the goods enumerated on this invoice are originating from the territory of Singapore/Chinese Taipei and they comply with the origin requirements specified for those goods in the ASTEP.
 
The information on this document is true and accurate and I assume the responsibility for providing such representations. I understand that I am liable for any false statements or material omissions made on or in connection with this document.
 
I agree to maintain and present upon request, documentation necessary to support this declaration of origin, and to inform, in writing, all persons to whom the declaration of origin was given of any changes that could affect the accuracy or validity of this certification.
 
8.   Name, Designation, Date and Signature:
 
 
 
 
INSTRUCTIONS FOR FILLING THE DECLARATION OF ORIGIN
 
The Declaration of Origin shall be completed by the exporter of the goods legibly in English. Annexes may be attached if the spaces provided are insufficient.
Field 1
Indicate legal name, address of the exporter.
Field 2
Indicate legal name, address of the importer.
Field 3
Indicate legal name, address of the producer, if known.
Field 4
Provide a full description of each good. The description shall be sufficiently detailed to relate it to the description of the good contained in the invoice, as well as with the description that corresponds to it in the Harmonised System (HS).
Field 5
For each good described in Field 4, identify the six digits corresponding to the HS tariff classification of the importing authority.
Field 6
For each good described in Field 4, identify the number and date of invoice. The invoice number should not be post‑dated.
Field 7
Declaration of origin as applicable:
a.For exports from Singapore, please declare “Singapore”;
b.For exports from Chinese Taipei, please declare “Chinese Taipei”.
Field 8
This field must be completed, signed and dated by the exporter or producer. The date must be the date the Declaration of Origin was completed and signed.
[S 263/2014 wef 19/04/2014]