【KCS Form 4】Korean Verification of Origin Questionnaire for Exporter or Producer
KOREA CUSTOMS SERVICEVERIFICATION OF ORIGIN QUESTIONNAIRE
(FOR EXPORTER OR PRODUCER)
This questionnaire is sent to you pursuant to Article O.OO of Korea-OO FTA and Article 13 of the Special Law on Customs Act for the implementation of Free Trade Agreement. It will be used in determining the preferential tariff treatment for imported good(s).
If necessary, additional information may be requested at a later date. Attached continuation pages may be usedif additional space is needed for your response.
Please return the completed sheets within ___ days after you receive this questionnaire. Regulatory measures such as denial of preferential tariff treatment may be provided if the due period is not met.
For an extension of the submission date, you may have a single opportunity to make a written request to the Customs Authority sending this questionnaire (Korea-Peru FTA excluded).
SECTIONⅠ ▶ TRADER INFORMATION
Exporter or producer mark √ where applicable and complete the following questionnaire.
Trader Status / Description
Exporter / You are the exporter of the good(s) subject to verification.
Exporter/Producer / You are the exporter and also the producer of the good(s) subject to verification.
Producer of Good(s) / You are the producer of the good(s) subject to verification.
Producer of Material(s) / You are the producer of the materials used in the production of the good(s) subject to verification.
Company Name / Overseas Supplier's No. / Country
Name of CEO / Business Type/Condition
Physical Address / (Head office) / Tel
Fax
Website
(Factory 1) / Tel
(Factory 2) / Tel
Personnel / (Total) persons (Board of Directors) persons
(Managers) persons (Production) persons (Others) persons
Consultants and Staffs in Origin Management / Third Party Consultants(Customs Broker, Consulting Firm, and/or Origin Specialist)
Name: /☎:
Origin Staff (Name: /☎: ), experienced for ____ yr(s)
Please provide information about human resources in charge of origin management
(※Attached continuation pagesmay be used if additional space is needed for your response.)
Origin Management System / Do you have an origin management manual? / Yes No
If yes, please provide (a copy of) the manual
Do you operate a system for origin management? / Yes No
Production Facilities for goods subject to verification / Description of Equipment / Quantity / Use / Location
(※Attached continuation pagesmay be used if additional space is needed for your response)
Manager in charge of OriginManagement / (Department) (Position) (Name) (Tel) (E-mail)
SECTION Ⅱ▶ GENERAL INFORMATION(based on each export declaration)
Applied FTA or Agreement
(Mark √ where applicable) / Korea-Chile Korea-Singapore Korea-EFTA Korea-ASEAN Korea-India
Korea-EU Korea-Peru Korea-US APTA GSP
1. DETAILS OF GOOD(S) SUBJECT TO VERIFICATION
Export Declaration No. / Date of Exportation
Description of good(s) / Specification of good(s)
HS Code / Price / Weight/Quantity
2-1. / How did you determineHS code of the exported good(s)? / Exporter's determinationConsulting broker
Advance Rulings Others (please specify: )
2-2. / For tariff classification, please mark √ where applicable and provide a copy of the documents
Transaction Contract Information of Production Process Bill of Material (BOM) Information of use
Advance Rulings on Tariff Classification Sample (※Your sample will not return if it is used for analysis)
2. CERTIFICATE OF ORIGIN (C/O)
2-1. / Issuer of the Certificate of Origin (C/O). / Government agency Exporter Producer
Importer Others (please specify: )
2-2. / Does the exporter keep C/O log book(s)? / Yes No Unknown
2-3. / Does the producer keep C/O log book(s)? / Yes No Unknown
2-4. / Which document is your determination of the preference rules of origin based on?Please mark √ where applicable and submit copy of supporting documents
Certificate of Origin / Invoice with certified origin
(including C/Os issued by third countries) / Cost and Production Statement
Origin certifying document
(※Supplier's Declaration (including blanket-exportations), domestic
manufacturing confirmation, Import Declaration etc.) / Others ( )
3. TRANSIT AND TRANSSHIPMENT
3-1. / Please mark √ where the transportation modes are indicated.
Bill of Lading (B/L) / Airway Bill (AWB) / Cargo Manifest / Others (please specify: )
3-2. / Did the exported good(s), on which a claim for preferential treatment was made, transit or transship a non-originating party while transported? / Yes No
3-3. / If you marked 'yes' to question 3-2, please provide supporting details proving that the good(s) remained under the control of Customs Authority of the non-originating party, and submit documentary evidences.
(※Supporting details.Attached continuation pagesmay be used if additional space is needed for your response.)
3-4. / Did the exported good(s) undergo further production or any other operation outside the territories of the Parties, other than unloading, reloading, or any other operation necessary to preserve the goods in good condition? / Yes No
3-5. / If you marked 'No' to question 3-4, please explain the detailed operation under the control of Customs Authority, and submit documentary evidences.
(※Explanation of the operation. Attached continuation pagesmay be used if additional space is needed for your response.)
SECTION Ⅲ▶PREFERENCIALRULES OF ORIGIN(based on each export declaration)
4. COMMON CRITERIA
4-1. / Does your company have manufacturing plant(s) and/or equipmentsinvolved in theproduction of the exported good(s) entitled to the preferential tariff treatment? / Yes No
4-2. / Did you carry out the production operations beyond the non-qualifying operations stipulated in the relevant Agreement? / Yes No
4-3. / Please state the country of production.
4-4. / Please provide physical address of the production facilities.
4-5. / If you have marked 'Yes' to question 4-2, provide copies of the documents proving the production.
4-6. / Please explain the manufacturing processes of the good(s) subject to verification.
(※Explanation of manufacturing process. Attached continuation pagesmay be used if additional space is needed for your response.)
Please mark √ indicating the appropriate preference rules applied to the good(s) being verified, and completethe question(s) below.
Preference Criterion / Please mark all the applicable rules you
applied. Complete the question
corresponding to the rule that apply. / Wholly obtained / Complete Question No. 5
Change in tariff classification / Complete Question No. 6
Regional value content / Complete Question No. 7
Manufacturing process / Complete Question No. 8
5. WHOLLY OBTAINED CRITERION
5-1 / Please describe the production operation for the good(s) subject to verification
(※Production Operation. Attached continuation pagesmay be used if additional space is needed for your response.)
5-2. / Provide the details of raw materials used in the production of the good(s) in the table below.
S/N / Description of Material / Type / HS Code / Name/Address of Supplier / Country of Origin
※ HS code: 6 or 8 digit code to be indicated according to the relevant Agreement.
Type: please refer to #7 of the attached 'Completion Instruction' and indicate one out of a through h.
Attached continuation pagesmay be used if additional space is needed for your response.
6. A CHANGE IN TARIFF CLASSIFICATION CRITERION
6-1. / Provide the details of raw materials used in the production of good(s) in the table below and provide supporting documents.
S/N / Description of Material / HS Code / Name of Supplier / Address/Contact Details
of Supplier / Country of Origin
(※Attached continuation pagesmay be used if additional space is needed for your response.)
6-2. / Provide the details of non-originating materials in the table below, which did not undergo a change in tariff classification. Provide supporting documents to substantiate a claim for the preferential treatment, e.g.based on De-minimis rule.
※For application of De-minimis rule, please check ifDe-minimis calculation is based on value or weight. Complete
only one of the two columns applicable.
S/N / Description of Material / HS Code / Country of Origin / Value / Weight
Total
(※Attached continuation pagesmay be used if additional space is needed for your response.)
Calculation based on Value / Value / Calculation based on Weight / Weight
Total value of Non-originating materials which did not undergo applicable tariff classification change / ① / Total weight of Non-originating materials which did not undergo applicable tariff classification change / ①
Total transaction value adjusted to FOB basis / ② / Total weight of the components / ②
or Total cost of the good
De Minimis percentage
= ①/②×100(%) / ③ / De Minimis percentage
= ①/②×100(%) / ③
ㅣㅏㅓ
8. REGIONAL VALUE CONTENT (RVC) CRITERION
8-1. / Fiscal year for calculating RVC.
8-2. / Provide details of raw materials used in the production of good in the table below, and submit cost accounting statement.
S/N / Material Description / HS Code / Supplier / Country of Origin / Unit Quantity / Unit Value / Value of Materials
Originating Material / Non-
originating Material
Total
(※Attached continuation pagesmay be used if additional space is needed for your response.)
8. MANUFACTURING PROCESSCRITERION
8-1. / Explain how this criterion is met and submit supporting documents.
(※Explanation on manufacturing process undertaken. Attached continuation pagesmay be used if additional space is needed for your response.)
9. FUNGIBLE GOODS/MATERIALS
9-1. / Does the good(s) subject to verification contain fungible goods? / Yes No
9-2. / If yes, select the inventory managementmethod used. / FIFO LIFO
AveragingOther acceptable method
9-3. / Provide the fungible good(s) used in the space below
(※Description of fungible goods. Attached continuation pagesmay be used if additional space is needed for yourresponse.)
9-4. / Does the good(s) subject to verification contain fungible materials? / Yes No
If yes, select the method applied for inventory management. / FIFO LIFO
AveragingOther acceptable method
Provide description of the fungible material(s) used in the space below.
(※Description of fungible materials. Attached continuation pagesmay be used if additional space is needed for your response.)
SECTION Ⅳ ▶ CERTIFICATION
We certify that the information on this document is true and accurate and we assume the responsibility for proving such representations. We understand that we are liable for any false statements or material omissions made on or in connection with this document.
Company Name / Date
Name of Representative / Title / Authorized Signature/Seal
Name of Person who Completed this Form / Title / Authorized Signature/Seal
Customs Use Only
Name of Customs / Division
Title / Name of person in charge
【Additional question or information】
※ If you have any questions or comments please state below. If further space is needed use the continuationpages.
.
List of Documents Submitted
S/N / Description of Documents / Question No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Completion Instruction
1. The confidential business information collected on the questionnaire may only be disclosed to those authorities responsible for
the administration and enforcement of determination of preference rules of origin, and of customs, and revenue regulations. If
necessary, additional information may be requested at a later date.
2. You will have to return the completed and signed questionnaire to the requesting Customs office. Regulatory measures such as
denial of preferential tariff treatment may be provided if the due period is not met.
3. Exporter and/or producer is required to keep all export/production-related documents relevant to exportation for 5 years from
the acceptance date of export declaration. The documents stated as below shall be submitted if requested by Customs.
※ Record keeping requirements are stipulated in the FTA and Enforcement Decree under the Special Law on Customs Act for
the implementation of Free Trade Agreement
FTA / Regulatory Basis / Documents entitled to Record KeepingEnforcement Decree
the Special
Law on
Customs Act / Paragraph 1
of Article 12
Paragraph 1.2
of Article 13 / ● A copy of the Certificate of Origin (including electronic records)
● A copy of Documents claiming for Origin Certification
● Certificate of Export Declaration
● Contract of Export Transaction
● Certificate of Export Declaration of materials used within the production of the good in question
● Documentary evidences proving production or purchase of the raw
materials and the good in question
● Cost Statement ● Bill of Material
● Production Process Instruction
● Log books of the good(s) and materials
● Origin certifying documents completed by the producer and submitted to the exporter in order to prove the origin of the good in question
● Origin confirmation or declaration completed by the producer in case where the local producer exists separately.
Korea-Chile / Paragraph 5
of Article 5.4 / ● All records relating to the origin of the good(s) for which
preferential tariff treatment was claimed
● Records relevant to purchase, cost and value of and payment for the exported good(s)
● Records relevant to purchase, cost and value of, and payment for all materials used in production of the exported good(s)
● Records regarding the production of the good(s) in the form in which the good is exported from its territory
● Certificate of Origin or Origin Declaration
Korea-Singapore / Paragraph 1
of Article 5.5 / ● All records relating to the origin of the good(s) for which
preferential tariff treatment was claimed
● Records relevant to purchase, cost, shipping and value of and payment for the exported good(s)
● Records relevant to sourcing, purchase, cost and value of, and payment for all materials used in production of the exported good(s)
● Records regarding the production of the good(s) in the form in which the good is exported from its territory
Korea-EFTA / Paragraph 1 and 3
of Article 21 of Annex I / ● Copy of the Origin Declaration, and of all documents supporting the originating status
● The records shall include electronic records
Korea-ASEAN / Paragraph 1 of Article 13, Appendix I / ● Records relevant to applying for issuance of Certificate of Origin pursuant to domestic laws and regulations of the exporting country
Korea-India / Paragraph 1 and 3
of Article 4.10 / ● the application for Certificate of Origin and all documents related to origin
● Exporter or producer may choose to maintain records specified in any medium that allows for prompt retrieval, including, but not limited to, digital, electronic, optical, magnetic or hard copy
FTA(Law) / Article / Record keeping data
Korea-EU / Paragraph 1 and 3
of Article 23
Paragraph 3
of Article 16 / ● Copy of Origin Declaration as well as documents stated in Article 16.3
● All appropriate documents proving the originating status of the product(s) concerned including statements from the suppliers or producers in accordance with domestic legislation as well as the fulfillment of the other requirements of the protocol
● The records may include electronic records
Korea-Peru / Paragraph 1, 2 and 4
of Article 4.6 / ● Documents related to the purchase, cost, value of and payment for the exported good(s)
● documents related to the purchase, cost, value of and payment for all materials including indirect materials used on the production of the exported good(s)
● Records regarding the production of the good(s) in the form in which the good is exported from its territory
● Other documents agreed by both parties
● Exporter or producer may choose to maintain records specified in any medium that allows for prompt retrieval, including, but not limited to, digital, electronic, optical, magnetic or hard copy
Korea-US / Paragraph 1 and 4
of Article 6.17 / ● All records necessary to demonstrate that the good for which the producer or exporter provided a certification was an originating good, including records concerning;
● the purchase, cost, value of and payment for the exported good(s)
● the purchase, cost, value of and payment for all materials including indirect materials used in the production of the exported good(s)
● Records regarding the production of the good(s) in the form in which the good is exported from its territory
● Other documents agreed by both parties
● Exporter or producer may choose to maintain records specified in any medium that allows for prompt retrieval, including, but not limited to, digital, electronic, optical, magnetic or hard copy
4. 6-digit or 8-digit HS Code shall be provided in accordance with the relevant FTA.
5. In terms of the value(price) of the goods and/or materials, please convert the value(price) of FOB, EXW, adjusted price, net
cost etc. into the US dollars.
6. Please describe the unit of quantityof the good set out in the harmonized commodity description and coding system. e.g. ㎏, u
㎏, 2u, m ㎏, ㎡ ㎏, ㎥ ㎏, ℓ ㎏, MW, etc.
7. For question 5-2, please complete the type of materials with reference to the below chart.
Classification / Type / Detailed ContextMineral products / a / mineral goods extracted from in territory of party
Vegetable products / b / vegetable products grown and harvested there
Live animals or goods
taken from them / c / live animals born and raised there, products from live animals raised there
Goods obtained by
hunting or fishing / d / goods obtained by hunting, trapping, fishing, aquaculture conducted there
Marine products / e / products of sea fishing taken by vessels registered with the party and entitled to fly its flag from the sea outside the sea territorial sea
Goods from universe / f / goods taken from outer space provided that they are obtained by the party or a person of the party
Waste, recycling goods / g / used articles collected there fit only for the recovery of raw materials or for use as waste
derived products / h / goods obtained or produced in the territory of party solely from goods referred to as above
※ Detailed classification of territory and product depends on the applied FTA.
8. For goods entitled to preference under Korea-US FTA, the importer may arrange for the exporter or producer to provide information proving that the good is originating directly to the Party.