[별지 제11호 서식] 증명서발급기관 등록서

The Issuing Authority of Korea

for Preferential Certificate of Origin

1. Name of Issuing Authority      (Issuing No : 000-yy-nnnnn  )

2. Postal Address.

Email Address.

Tel No.

Fax No.

3. Treaty․Agreement :

4. Official Stamp

5. Specimen Signature of Authorized Signatories

Position	Name	Specimen Signature

6. Date of Enforcement :