ANHANG II VO (EU) 2023/2834

Muster des Echtheitszeugnisses gemäß Artikel 9 Absatz 1

Das Formblatt hat ein Format von etwa 210 × 297 mm. Für das Original ist Papier zu verwenden, das jede durch mechanische oder chemische Einwirkung vorgenommene Fälschung erkennen lässt.

Die Formblätter werden in englischer Sprache gedruckt und ausgefüllt.

Das Original und das Duplikat werden entweder maschinenschriftlich oder von Hand ausgefüllt. Im letzteren Fall müssen Tinte und Großbuchstaben verwendet werden.

Jedes Echtheitszeugnis trägt im rechten oberen Feld eine laufende Nummer. Das Duplikat trägt dieselbe Nummer wie das Original.

NB:: This certificate is issued in conformity with the national legislation.

1. Exporter (Name and full address)	CERTIFICATE OF AUTHENTICITY BASMATI RICE for export to the European Union
2. Consignee (Name and full address)
	No⁽¹⁾	ORIGINAL
	issued by (Name and full address of issuing body)
	3. Country and place of cultivation
	4. FOB value in US dollars
	5. Number and date of invoice
6. Marks and numbers — Number and kind of packages — Description of goods⁽²⁾		7. Gross weight (kg)
		8. Net weight (kg)
9. DECLARATION BY EXPORTER The undersigned declares that the information shown above is correct.
Place and date:	Signature:
10. CERTIFICATION BY THE ISSUING BODY It is hereby certified that the rice described above is BASMATI RICE and that the information shown in this certificate is correct.
Place and date:	Signature:	Stamp:
11. CERTIFICATION BY COMPETENT CUSTOMS OFFICE OF COUNTRY OF EXPORT Customs formalities for export to the European Union of the rice described above have been completed. Type, number and date of export document: Name and country of customs office:
	Signature:	Stamp:
12. FOR COMPETENT AUTHORITIES IN THE UNION

Fußnote(n):

(1)

The number of the certificate of authenticity shall be a number of a continuous series given by the country delivering the certificate.

(2)

The operator shall specify:

—: for marks and numbers: the reference and number of the batch,
—: for number and kind of packages: the number and weight of packages,
—: for the description of goods: the information on the rice, the CN code as well as the variety or varieties, which shall be on the list provided for in Commission Delegated Regulation (EU) 2023/2835. The description of goods should correspond to the information included in the invoice, the number and date of which is specified in box 5.

ANHANG I ANHANG III

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