* Certificate of Origin (Non Preferential)
[F- Goods consigned Form
(Exporters business name, adsress, county)
[ASHIDA Electonics Pv Li,
Pict No-A-308,
Road No-21, MLLD.C.Wagle Indl Estate
‘Thane, MAHARASHTRA 400604. (Indi)
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Farece No, TOCGRET- 8. NO 19 6
CODE NO. :TSSIA -EIC- 105M
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CERTIFICATE OF ORIGIN (NON PREFERENTIAL) ISSUED IN INDIA
‘THANE SMALL SCALE INDUSTRIES ASSOCIATION
‘TSSIA HOUSE. Plot No. P-26, Road Not BIT, Wagle Industri
Estate, Thane 400604. ( MAHARASHTRA, INDIA )
‘Phone 022-25820428 25822403 Fax: 25623303
mal ssa thane @grail.com,issiat975@gmailcom
Fz Means of anspor and route (as far as Known)
{TNT (Air) Port incia To Vietnam
3 Foroffice use
Stem 6. [7. Numberand kind of packages, |B. Origin |S. Gross weight 10. Number
number |Numbers of packages |description of goods (Criteria Jor other quantity |and date of
invoices
1 Total 01 Box RELAY wNo1a | Total Gross Weight | 19-2008
Remote Terminal Unit 10k9 02078 Dated
AFRTU with 23 DI & 8 DO 8 DO for 21-11-2020,
Harawing & Modbus RTU serial Por -
Central Processor RTU
¥9/24180001 - 19124150010
HSN Code : 85354900,
Declaration by the Exporter
Certification
Certified that the goods specified herein are of indian|
(Origin / Manufacturer It is hereby certified, on the basis|
lof control carried out, that the declaration by the|
lexporter is correct
Place: Thane ; Date 2 1 NOV 2020
‘The undersigned hereby declares that the above details
land statements are correct; that all the goods were|
[produced in India and that they comply with the origin|
requirements for exports to Vietnam _(ireoring county
Signature of authorized signatory and Stamp
Place: Thane Date: 21-11-2020