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  1. Certificate of Materials Imported from Japan Annex to Certificate of Origin Ref. No. ____________________ CERTIFICATE OF MATERIALS IMPORTED FROM JAPAN WHICH WERE USED FOR MANUFACTURE OF THE GOODS DESCRIBED IN CERTIFICATE OF ORIGIN (Ref. No. _________________________) Issued in Vietnam Export Goods Materials imported from Japan Description Quantity Description Quantity Certification Declaration by the exporter It is hereby certificated, on the basis of control carried The undersigned hereby declares that the above details are out, that the declaration by the exporter is correct. correct. ---------------------------------------------------------------------- ----------------------------------------------------------- Place and date, signature and stamp of certifying authority Place and date, signature of authorized signatory