NO.44 SIII{CEI KADUT AVENUE. SINCAPORE 729667 oRtGtl{Ar k CERTI FICATE OF ORIG I N/PREGS{NG No. t] g 7 34 NO UNAUTHORISED ADDITION/ALTERATION MAY BE 2 Consignee (Name, Full Address & Country) PT GLOBAL TRADING JL. RUKO VILLA CADING INDAH BL A2l2. KALAPA GADING BARAT JAKARTA UTARA 14241 INDONESIA 3 Departure Date ApRtL 04.2014 IN MIN(; [{t \ clare that the details and Signature: ., ONG SI()K I ING NAME: ADMIN MANACER Designation: APRIL 08, 2014 Date: 4 Vessel's Name/Flight No. Lpstant 5 Port of Discharge JAKARTA. INDONESIA 6 Country of Final DestinatiorUAKARTA. INDONESIA 7 Country of Origin of Goods MADE IN JAPAN & INDONESIA 11 Quantity & L,nit I l\ilarks & 10 No. & Kind of Packages Numbers Description of Goods (include brand names il necessary) CI,OBAL TRADINC GENUINE MITSUBISHI SPARE PARTS .2603/cT1/pUR-03/03 14 PARI' NO SUPPLIED DESCRIPTIOII OUANTITI COUNTRY OF ORIGTN ]/) 3751913100 BRG CONROD 12 PCS JAPAN 37561 I75OO TIP ASSY 6 PCS JAPAN 37540111004 ELEMENT OIL 8 PCS INDONESIA 3754OO2IOOA FILTER CART 4 PCS INDONESIA 3256260200 ELEMENT 8 PCS JAPAN 37s4008511 ELEMENT OIL WW (S6R2) 4 pCS JAPAN 4278300115 SEAL ASSY WATER 2PCS JAPAN REMARKS: ALL THE ITEMS SHIPPED UNDER INVOICE NO, 140010858 ARE CENUTNE MITSUBISI-II PARTS AND MADE IN JAPAN & INDONESIA. TOTAL QUANTITY: 44 PCS ONLY 'xl'iff 1..,.lllT:,i];i[iT,,?,,8?yy.:.Fil.:|?TIE' .l0 APR 201t 12 CERTIFICATION BY THE COT'PETENT AUTHORITY We hereby certify that evdence has been produced io satisfy us that the goods specified above originate in/were processed in the country shown in box 7. This Certificate is therefore issued and certified to the best of our knowledge and belief to be correct and without any iiability on our part. t\'u....... \cArEnor-