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1. IMPORTED MATERIALS AND COMPONENTS(INCLUDING THOSE OF UNDETERMINED ORIGIN)LIST.

HS	Description	Q'ty	Unit price in CIF US$	Total amount in CIF US$

2. DOMESTIC MATERIALS AND COMPONENTS LIST

HS	Description	Q'ty	Unit price in CIF US$	Total amount in CIF US$	Name of Supplier

3. UNIT PRICE OF THE EXPORTED GOODS IN US $

Ex-factory unit price

Inland Freight

Other charges

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FOB Korea

Ocean Freight

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C&F (Destination)

Insurance

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CIF (Destination)

4. (가) THE RATE OF EXPORT NET-EARTING. (일본지역)

Ex-Factory Value-Imported Materials and

(US $)   Components in CIF(US $)

□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□ ×100 =         %

Ex-Factory Value(US $)

(나) THE RATE OF IMPORTED MATERIAL AND PARTS. (카나다지역)

Value of imported Materials and Parts

□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□ ×100 =       %

Ex-Factory cost