XXXXXXX LIMITED Address APPENDIX B EXPORTERS STATEMENT OF ORIGIN I certify that the goods described in this invoice or in the attached invoice no. XXX /2017 was produced in the beneficiary country of BANGLADESH and that at least 100 % of the ex-factory price of the goods originates in the beneficiary country/ countries of BANGLADESH . (Managing Director) Name & Title Corporation Name & Address Telephone & Fax Numbers 10/10/2017 Signature & Date (Day/Month/Year)
