CERTIFICATE OF ORIGIN

1. Exporter’s Name, Address and Certification No. Number of page

Country: 2 0 2 4 1 3 5 7 9 0 2 4 6 8 2 1 8 0 1/1
Masashi Nagayasu
Add: 4261 Ikonobe-cho, Tsuzuki-
ku, Yokohama City, Kanagawa
224-8520, Japan AGREEMENT BETWEEN JAPAN AND THE SOCIALIST
2. Importer’s Name or Consignee’s REPUBLIC OF VIET NAM FOR AN ECONOMIC
Name (if applicable), Address PARTNERSHIP
and Country:

Tran Truong Gia Bao CERTIFICATE OF ORIGIN

Form JV
Add: 6868 2/9 Street, Hai Chau
Issued in Japan
District, Da Nang City, Vietnam
3. Transport details (means and route)
(if known):
Date of shipment: June 30,2024
Port of discharge: Da Nang City
Name of loading point: Yokohama
Port

4. Item number (as necessary); Marks and numbers; 5. Preferen 6. Weight 7.Invoice
ce
Number and kind of packages; HS code; criteria or other number(s)
Description of good(s): quantity and date(s)

100 units JPVN20240

Multi-door refrigerator made in Japan - NR-F503GT-X2 100 units 6

Multi-door refrigerator made in Japan - NR-F603GT-X2 100 units June 3, 2024

CTH
Microwave grill - NN-GM34NBYUE 100 units
Microwave grill - NN-GT35NBYUE 100 units
TV 55-inch, LED, 4K HDR - TH-55LX800V

Marks and numbers: Electronic: PANASONIC

AUTOMOTIVE SYSTEMS CO., LTD

Made in Japan

Number and kind of packages: 270 pallets

8. Remarks: Issued Retroactively
9. Declaration by the exporter: 10.Certification
I, the undersigned, declare that: It is hereby certified, on the basis of control carried out, that the
- the above details and statement are true declaration by the exporter is correct.
and accurate.
- the good(s) described above meet Competent governmental authority or Designee office:
the condition(s) required for the The Japan Chamber of Commerce and Industry

issuance of this certificate; Stamp

- the country of origin of the good(s)

described above is JAPAN

Place and Date: Yokohama, June 3,

2024

Place and Date: Yokohama, June 3, 2024

Signature: Name (printed): Masashi Nagayasu

Signature:

Name (printed): Masashi Nagayasu

Company: PANASONIC
AUTOMOTIVE SYSTEMS CO., LTD
Parties which accept this form for the purpose of preferential treatment under the Agreement between Japan and
the Socialist Republic of Vietnam for an Economic Partnership are Japan and Vietnam.
General Conditions:
The conditions for the preferential tariff treatment under the Agreement are that the goods exported to Japan or Vietnam
should:
I. fall within description of goods eligible for concession in Japan or Vietnam;
II. comply with the consignment conditions in accordance with Article 31 of the Agreement; and
III. comply with the preference criteria provided for in Chapter 3 of the Agreement.
Instructions for Certificate of Origin:
For the purposes of claiming preferential tariff treatment, the CO should be completed legibly and in full by the
exporter or its authorized agent and certificated by the competent governmental authority or its designee. Any
item in the CO should be completed in the English language. The CO should be no longer valid, if it is modified
after the issuance.
If the space of the form of the CO is insufficient to specify the necessary particulars for identifying the goods and other
related information, the exporter or its authorized agent may provide the information using additional Appendix 1-A.
In that case, every additional Appendix 1-A of the Implementing Regulations should be completed legibly and in full
by the exporter or its authorized agent and certificated by the competent governmental authority or its designee.

Box 1: State the full name, address and country of the exporter.
Box 2: State the full name, address and country of the importer. As defined in subparagraph (g) of Article
23 of the Agreement, “importer” means a natural or juridical person who imports a good into the
importing Party (e.g. the consignee who declares the importation).
Box 3: Provide the name of loading port, transit port and discharging port, and the name of vessel or flight
number, if known. In case of retroactive issuance, the date of shipment (i.e. bill of lading or airway
bill date)
Box 4: Provide item number (as necessary), marks and numbers, number and kind of packages, HS code as
amended on January 1, 2007, and description of each good consigned.
For each good, the HS code should be indicated at the six-digit level (or a more detailed level as
is established by the importing Party if required by the exporting Party).
The description of the good on a CO should be substantially identical to the description on the invoice
and, if possible, to the description under the HS for the good.
With respect to subheading 0910.99, 1515.90, 2208.90 and 9404.90, in an exceptional case where the
good is a good requiring a specific description (e.g. curry, tung oil and its fractions), such description
of specific products should be indicated.
With respect to each good of Chapter 50 through 63 of the HS, the materials of the other Party or non-
Parties which are member countries of the ASEAN, the process or operation conducted in such Party
or non-Parties, and the names of such Party or non-Parties should be indicated (if such materials were
used in the production of the good).
Box 5: For goods that meet the preference criteria, the exporter or its authorized agent should indicate in box 5
of this form, the preference criteria met, in the manner shown in the following table or any combination of
acronym contained therein:

Circumstances of production or manufacture in the Party Insert in box 5

named in box 9 of this form
(a) Wholly obtained goods satisfying Article 25 of the “WO”
Agreement
(b) Goods satisfying paragraph 1 of Article 26 of the
Agreement “CTH” or “LVC”
(c) Goods satisfying paragraph 2 of Article 26 of the
Agreement
- Change in Tariff Classification “CTC”
- Local Value Content “LVC”
- Specific Manufacturing or Processing Operation “SP”
(d) Goods satisfying subparagraph (c) of Article 24 of the “PE”
Agreement
Also, exporters should indicate the following where
 applicable:
(e) Should goods comply with Article 28 of the “DMI”
Agreement
(f) Should goods comply with Article 29 of the “ACU”
Agreement
(g) Should goods comply with Article 35 of the “IIM”
Agreement

Box 6: For each good, indicate the weight or other quantity (e.g. gross weight or net weight).
Box 7: Indicate the invoice number and date for each good. The invoice should be the one issued for the importation
of the good into the importing Party.
If the invoice is issued by a person different from the exporter to whom the CO is issued and the
person who issues the invoice is located in a non-Party, it should be indicated in box 8 that the
goods will be invoiced in a non-Party, identifying the full legal name and address of the person that
issues the invoice.
In an exceptional case where the number of the invoice issued in a non-Party is not known at the time
of issuance of the CO, the invoice number and the date of the invoice issued by the exporter to whom
the CO is issued should be indicated in box7, and it should be indicated in box 8 that the goods will be
subject to another invoice to be issued in a non-Party for the importation into the importing Party,
identifying the full legal name and address of the person that will issue such other invoice. In such
case, the customs authority of the importing Party may require the importer to provide the invoices
and any other relevant documents which confirm the transaction, from the exporting Party to the
importing Party, with regard to the goods declared for import.
Box 8: If the CO is issued retroactively, the competent governmental authority or its designee should
indicate “Issued Retroactively”. If the CO is newly issued in accordance with Rule 4(b)(ii) and
5(a) of the Implementing Regulations, the competent governmental authority or its designee should
indicate the date of issuance and the certification number of the original CO. In cases of Certified
True Copies, in accordance with Rule 5 (b) of the Implementing Regulations, the words
“CERTIFIED TRUE COPY” should be indicated in box 8. Other remarks as necessary.
Box 9: This box should be completed, signed and dated by the exporter or its authorized agent. “Date” should be the
date when the CO is applied for.
Note: The exporter’s or its authorized agent’s signature may be autographed or electronically printed.
Box 10: This box should be completed, dated, signed and stamped by the competent governmental authority of the
exporting Party or its designee.
Note: The competent governmental authority’s or its designee’s signature may be autographed or
electronically printed. Official seals or impression of stamps on a CO of the competent
governmental authority of the exporting Party or its designees may be manually put or
electronically printed.
Notice 1: Any items entered in this form should be true and correct. False declaration or documents relating to
the CO should be subject to penalty in accordance with the laws and regulations of the exporting
Party.
Notice 2: The CO should be a basis of determination of origin at the customs authority of the importing Party.