Specimen of the accompanying document referred to in Article 2(1)
ANNEX ISupplementary provisions
ANNEX I Specimen of the accompanying document referred to in Article 2(1) Text of image ORIGINAL ACCOMPANYING DOCUMENT UNDER COUNCIL REGULATION No 866/2004 No: 00001 Producer (name, or name of firm, and full address): Consignor (name, or name of firm, and full address): Consignee (name, or name of firm, and full address): Description of goods, item number, marks, numbers, number and kind of packages (for goods not packed indicate number or in bulk): Volume/quantity Transaction value Net weight (kg)/other units of measure Declaration by the consignor The goods mentioned in this document are: Destined for consumption in Cyprus Not destined for consumption in Cyprus. Please specify country of destination: DateSignature Certification of the Turkish Cypriot Chamber of Commerce It is hereby certified, on the basis of controls carried out, that the above-mentioned goods originate, within the meaning of Articles 23 and 24 of Council Regulation (EEC) No 2913/93, in the areas as defined in Article 1(1) of Protocol No 10 of the Act of Accession 2003 and that the specifications given by the producer are accurate. Date Authorised signature and stamp