4380 NEW ZEALAND GAZETTE No. 169

APPLICATION FOR A CUSTOMS RULING
(COUNTRY OF PRODUCE OR MANUFACTURE)
(Under S119 (1)(c) of the Customs and Excise Act 1996)

Te Mana Arat o Aotearoa

APPLICANT’S DETAILS

Applicant: ....................................................................................................................

Applicant’s Address: .................................................................................................................

Agent (if applicable): ..............................................................................................................

Agent’s Address: ..................................................................................................................

Contact Person: .................................................................................................................

Phone Number: .................................................... Fax Number: ...........................................

Describe The Particular Goods That Are The Subject Of The Application

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Provide Details Of The Manufacturer Of The Goods (including name, address, phone number) If This Is A Different Person From The Applicant

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The Country Or Country Group Relating To The Application

Country or Country Group Tick appropriate box

Australia ☐

Canada ☐

Malaysia ☐

Singapore ☐

United Kingdom of Great Britain and Northern ☐ Specific Country: ..........................................
Ireland, the IsIc of Man, and the Channel Islands

Developing Countries (LDC & LLDC) ☐ Specific Country: ..........................................

Forum Island Countries (SPARTECA) ☐ Specific Country: ..........................................

Specify Origin Category Relating To The Application

Origin Category Tick appropriate box

Unmanufactured raw products/goods wholly obtained/goods wholly produced/
goods wholly produced or obtained (delete categories not applicable) ☐

Goods wholly manufactured ☐

Goods partly manufactured ☐