[별지 제4-13호 서식] 소요량증명(신청)서
①신청인(상호 , 주소, 성명) (서명 또는 인)					②발급근거서류명 및 번호
					③용도
					④소요량고시번호
수출품 또는 군납용명세
⑤HS부호	⑥품명 및 규격		⑦단위 및 수량			⑧가격조건 및 단가		⑨단가	⑩비고
소요원료명세
⑪HS부호 (10단위)		⑫품명 및 규격		⑬단위 및 수량			⑭비고
⑮발급번호
위의 신청사항을 대외무역관리규정 제4-3-2조 내지 제 4-3-5조의 규정에 의하여 증명합니다. 년 월 일 발 급 권 자 (서명 또는 인)
2812-281-03811민 210㎜ × 297㎜ ’98.1.12. 승인 일반용지 60g/㎡

1. Goods consigned(exporter's business name, address, country)			Reference No GENERALIZED SYSTEM OF PREFERENCES CERTIFICATE OF ORIGIN (Combined declaration and certificate) FORM A REPUBLIC OF KOREA issued in --------------------------- (country) See notes overleaf
2. Goods consigned to(consignee's name, address, country)
3. Means of transport and route(as far as known)			4. For official use
5. Item num- ber	6. Marks and numbers of package	7. Number and kind of packages; description of goods		8. Origin criterion (see notes overleaf)	9. Gross weight or other quantity	10. Number and date of invoices
11. Certification It is hereby certified, on the basis of control carried out, that the declaration by the exporter is correct. ............................................................... Place and date, sognature and stamp of certifying authority			12. Declaration by the exporter The undersigned hereby declares that the above details and statements are correct:that all the goods were REPUBLIC OF KOREA produced in------------------------- (country) and that they comply with the origin requirements specified for those goods in the generalized system of preferences for goods exported to ................................................................. (importing country) ................................................................. Place and date, signature of authorized signatory