【KCS Form 4】Korean Verification of Origin Questionnaire for Exporter or Producer
KOREA CUSTOMS SERVICE
VERIFICATION 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 used if
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
Material(s)
of
You are the producer of the materials used in the production of the good(s) subject
to verification.
Overseas
Supplier's No.
Business
Type/Condition
Company Name
Name of CEO
Country
(Head office)
Tel
Fax
Physical Address
Personnel
Consultants and
Staffs in Origin
Management
Website
(Factory 1)
Tel
(Factory 2)
Tel
(Total)
(Managers)
persons
persons
(Board of Directors)
(Production)
persons
persons
(Others)
persons
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 pages may be used if additional space is needed for your
response.)
Origin
Management
System
Production
Facilities for goods
subject to
verification
Do you have an origin management manual?
Yes
No
Yes
No
If yes, please provide (a copy of) the manual
Do you operate a system for origin management?
Description of
Equipment
Quantity
Use
Location
Manager in charge
of Origin
Management
(※ Attached continuation pages may be used if additional space is needed for your
response)
(Department)
(Position)
(Name)
(Tel)
(E-mail)
SECTION Ⅱ ▶ GENERAL INFORMATION (based on each export declaration)
Korea-Chile
Applied FTA or Agreement
Korea-Singapore
Korea-EFTA
Korea-ASEAN
Korea-
India
(Mark √ where applicable)
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
Exporter's determination
Advance Rulings
specify:
)
Consulting broker
Others (please
2-1.
How did you determine HS code of the exported
good(s)?
2-2.
For tariff classification, please mark √ where applicable and provide a copy of the documents
Transaction Contract
Information of use
Information of Production Process
Advance Rulings on Tariff Classification
analysis)
Bill of Material (BOM)
Sample (※Your sample will not return if it is used for
2. CERTIFICATE OF ORIGIN (C/O)
Government agency
Importer
specify:
)
Exporter
Producer
Others (please
2-1.
Issuer of the Certificate of Origin (C/O).
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
Origin
Certificate
of
Invoice with certified origin
(including C/Os issued by
countries)
third
Origin certifying document
(※Supplier's
Declaration
(including
blanket-exportations),
domestic
manufacturing confirmation, Import Declaration etc.)
Cost and Production Statement
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
specify:
Others
)
Yes
(please
No
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?
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 pages may 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 pages may be used if additional space is needed
for your response.)
SECTION Ⅲ ▶ PREFERENCIAL RULES OF ORIGIN (based on each export declaration)
4. COMMON CRITERIA
4-1.
Does your company have manufacturing plant(s) and/or equipments involved in the
production 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 pages may 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 complete
the question(s) below.
Preferenc
e
Please mark all the applicable rules
you
applied. Complete the question
Criterion
corresponding to the rule that apply.
Wholly obtained
Change
classification
Complete Question No. 5
in
tariff
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 pages may 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 pages may 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 pages may be used if additional space is needed for your response.)
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.
6-2.
※ For application of De-minimis rule, please check if De-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
Total
Value
Weight
(※ Attached continuation pages may be used if additional space is needed for your response.)
Calculation based on Value
Total
value
of
Nonoriginating materials which
did not undergo applicable
tariff classification change
Total
transaction
value
adjusted to FOB basis
Value
①
Total weight of Nonoriginating materials which
did not undergo applicable
tariff classification change
①
②
Total
weight
components
②
③
De Minimis percentage
= ①/②×100(%)
or Total cost of the good
De Minimis percentage
= ①/②×100(%)
Calculation based on Weight
of
the
Weight
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.
Value of Materials
S/N
Material
Description
HS Code
Supplier
Country
of Origin
Unit
Quantity
Unit
Value
Originating
Material
Total
(※ Attached continuation pages may be used if additional space is needed for your response.)
8. MANUFACTURING PROCESS CRITERION
8-1.
Explain how this criterion is met and submit supporting documents.
Nonoriginating
Material
(※ Explanation on manufacturing process undertaken. Attached continuation pages may 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?
9-2.
If yes, select the inventory management method used.
9-3.
Provide the fungible good(s) used in the space below
Yes
No
FIFO
LIFO
Averaging
Other acceptable
method
(※ Description of fungible goods. Attached continuation pages may be used if additional space is needed
for your response.)
9-4.
Does the good(s) subject to verification contain fungible materials?
If yes, select the method applied for inventory management.
Yes
No
FIFO
LIFO
Averaging
Other acceptable
method
Provide description of the fungible material(s) used in the space
below.
(※ Description of fungible materials. Attached continuation pages may 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 continuation
pages.
.
List of Documents Submitted
S/N
1
2
3
4
5
6
7
Description of Documents
Question No.
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 Keeping
Enforcement
Decree
Paragraph 1
of Article 12
the Special
Law on
Customs Act
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.
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
KoreaSingapore
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
KoreaASEAN
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
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
Korea-Chile
Korea-India
FTA(Law)
Korea-EU
Korea-Peru
Article
Record keeping data
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
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 quantity of 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 Context
Mineral 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.