О ТАМОЖЕННОМ ОФОРМЛЕНИИ ТОВАРОВ С ПРИМЕНЕНИЕМ КАРНЕТОВ АТА. Распоряжение. Государственный таможенный комитет РФ (ГТК России). 20.12.02 777-Р


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                       О ТАМОЖЕННОМ ОФОРМЛЕНИИ
                  ТОВАРОВ С ПРИМЕНЕНИЕМ КАРНЕТОВ АТА

                             РАСПОРЯЖЕНИЕ

                ГОСУДАРСТВЕННЫЙ ТАМОЖЕННЫЙ КОМИТЕТ РФ

                          20 декабря 2002 г.
                               N 777-р

                                 (Д)


     В целях    реализации   положений   Постановления   Правительства
Российской Федерации от 2 ноября  1995  г.  N  1084  "О  присоединении
Российской   Федерации  к  Таможенной  конвенции  о  карнете  АТА  для
временного ввоза товаров от 6 декабря 1961 г.  и Конвенции о временном
ввозе  от  26  июня  1990  г.  с  принятием ряда приложений" (Собрание
законодательства Российской Федерации,  1995,  N  45,  ст.  4339),  на
основании ст.  174 Таможенного кодекса Российской Федерации (Ведомости
Съезда народных депутатов Российской  Федерации  и  Верховного  Совета
Российской Федерации,  1993, N 31, ст. 1224; Собрание законодательства
Российской Федерации,  1995, N 26, ст. 2397; 1996, N 1, ст. 4; 1997, N
30, ст. 3586; N 47, ст. 5341; 1999, N 7, ст. 879; 2002, N 1 (часть I),
ст.  2;  N 27,  ст.  2620;  N 22,  ст.  2026),  обращения Генерального
секретаря   Всемирной   таможенной   организации   от   21.06.2002   N
02.PL-0110E/A.R. обязываю:
     1. Таможенные   органы   Российской   Федерации,   уполномоченные
производить  таможенное  оформление  и  таможенный  контроль  товаров,
перемещаемых   через   таможенную   границу   Российской  Федерации  с
применением карнетов АТА, принимать для целей таможенного оформления:
     а) начиная  с  18  декабря 2002 года новый бланк проформы карнета
АТА (приложение);
     б) до 18 декабря 2004 года старый бланк проформы карнета АТА.
     2. Начальников  региональных  таможенных  управлений  и  таможен,
непосредственно  подчиненных ГТК России,  довести положения настоящего
распоряжения до сведения подчиненных должностных  лиц,  уполномоченных
производить таможенное оформление и таможенный контроль товаров.
     3. Первому заместителю  председателя  ГТК  России  Л.А.  Лозбенко
осуществлять контроль за исполнением настоящего распоряжения.

Председатель Комитета
действительный государственный
советник таможенной службы
Российской Федерации
                                                             М.В.ВАНИН


                                                            Приложение

                                             к распоряжению ГТК России
                                                         от 20.12.2002
                                                               N 777-р

Issuing Association                  INTERNATIONAL GUARANTEE CHAIN
Association emettrice                CHAINE DE GARANTIE INTERNATIONALE

                       ATA CARNET / CARNET ATA
                   FOR TEMPORARY ADMISSION OF GOODS
             POUR L`ADMISSION TEMPORAIRE DES MARCHANDISES
               CUSTOMS CONVENTION ON THE A.T.A. GARNET
                 FOR THE TEMPORARY ADMISSION OF GOODS
              CONVENTION DOUANIERE SUR LE GARNET A.T.A.
             POUR L`ADMISSION TEMPORAIRE DE MARCHANDISES
                  CONVENTION ON TEMPORARY ADMISSION
             CONVENTION RELATIVE A L`ADMISSION TEMPORAIRE

(Before completing the Garnet, please read Notes on cover page 3/Avant
de remplir le carnet, lire la notice en page 3 de la couverture)
--------------------------------------------------------------------------------------------------
|A | C        |A. HOLDER AND ADDRESS /  |G. FOR ISSUING ASSOCIATION USE / Reserve a l`association|
|T | A        |   / Titulaire et adresse|                           emettrice                    |
|A | R        |                         |                   FRONT COVER / Couverture             |
|  | N        |                         |--------------------------------------------------------|
|  | E        |                         |a) CARNET No.                             --------------|
|C | T        |                         |   Carnet N                               |            ||
|A |          |                         |   Number of continuation sheets: ....... --------------|
|R |          |                         |   Nombre de feuilles supplementaires                   |
|N | A        |-------------------------|--------------------------------------------------------|
|E | T        |B. REPRESENTED BY <*> /  |b) ISSUED BY / Delivre par                              |
|T | A        |   / Represente par <*>  |                                                        |
--------------|                         |                                                        |
TO BE RETURNED|                         |                                                        |
TO THE ISSUING|-------------------------|--------------------------------------------------------|
CHAMBER       |C. INTENDED USE OF GOODS |c) VALID UNTIL / Valable jusqu`au                       |
IMMEDIATELY   |   / Utilisation prevue  |                                                        |
AFTER USE / A |   des marchandises      |                                                        |
RETOURNER A LA|                         |.............. / .................. / ..................|
CHAMBRE       |                         |    year               month            day (inclusive) |
EMETTRICE     |                         |    annee              mois             jour (inclus)   |
IMMEDIATEMENT |                         |                                                        |
APRES         |----------------------------------------------------------------------------------|
UTILISATION   |P. This carnet  may be used in the following countries / Customs territories under|
              |   the guarantee of the associations listed on page four of the cover: / Ce carnet|
              |   est  valable  dans les pays / territoires douaniers ci-apres,  sous la garantie|
              |   des associations reprises en page quatre de couverture:                        |
              |                                                                                  |
              |                                                                                  |
              |                                                                                  |
              |                                                                                  |
              |                                                                                  |
              |                                                                                  |
              |   The holder of this Carnet and his representative  will be held responsible  for|
              |   compliance with the laws  and regulations of the country / Customs territory of|
              |   departure  and  the  countries / Customs territories of importation. / A charge|
              |   pour le titulaire et son representant de se conformer aux lois et reglements du|
              |   pays / territoire douanier  de  depart et  des  pays / territoires    douaniers|
              |   d`importation.                                                                 |
              |----------------------------------------------------------------------------------|
              |H. CERTIFICATE BY CUSTOMS AT DEPARTURE /       |I. Signature of authorised        |
              |   Attestation de la douane, au depart         |   official and issuing           |
              |                                               |   Association stamp / Signature  |
              |                                               |   du delegue et timbre de        |
              |                                               |   l`association emettrice        |
              |a) Identification marks have been affixed as   |                                  |
              |   indicated in column 7 against the following |                                  |
              |   item No(s) of the General List              |                                  |
              |   Appose les marques d`identification         |                                  |
              |   mentionnees dans la colonne 7 en            |                                  |
              |   regard du (des) numero(s) d`ordre           |                                  |
              |   suivant(s) de la liste generale ........... |                                  |
              |   ........................................... |                                  |
              |                                               |                                  |
              |b) GOODS EXAMINED <*> / Verifie les            |                                  |
              |   merchandises <*>                            |                                  |
              |                                               |                                  |
              |   Yes / Oui          No / Non                 | ............. / ....... / ...... |
              |                                       --------| Place and Date of issue          |
              |c) Registered under Reference No ..... |      || (year / month / day)             |
              |   Enregistre sous le numero <*>.      |      || Lieu et date d`emission (annee / |
              |                                       --------| mois / jour)                     |
              |                                               |----------------------------------|
              |d) ............................................| J.                               |
              |    Customs  Place  Date (year /  Signature and|                                  |
              |    Office          month / day)     stamp     | X..............................X |
              |    Bureau   Lieu   Date (annee / Signature et |  Signature of Holder /Signature  |
              |   de douane        mois / jour)     timbre    |            du titulaire          |
              ------------------------------------------------------------------------------------

     --------------------------------
     <*> If applicable / <*> S`il y a lieu.

                                                   лист зеленого цвета


A.T.A. CARNET                                            CARNET A.T.A.

                    GENERAL LIST / LISTE GENERALE

                                             оборотная сторона листа 3

-----------------------------------------------------------------------------------
|Item |Trade description  | Number  |Weight  |Value /|<**>      |For Customs Use /|
|No/N |of goods and marks |   of    |  or    |Valeur |Country of|  Reserve a la   |
|d`   |and numbers, if    |Pieces / |Volume /| <*>   |origin /  |     douane      |
|ordre|anyl               | Nombre  |Poids ou|       |<**> Pays |  Identification |
|     |Designation        |   de    | Volume |       |d`origine |     marks /     |
|     |commerciale des    | Pieces  |        |       |          |     Marques     |
|     |marchandises et, le|         |        |       |          |d`identification |
|     |cas echeant,       |         |        |       |          |                 |
|     |marques et numeros |         |        |       |          |                 |
|-----|-------------------|---------|--------|-------|----------|-----------------|
|  1  |         2         |    3    |    4   |   5   |    6     |         7       |
|-----|-------------------|---------|--------|-------|----------|-----------------|
|     |                   |         |        |       |          |                 |
|     |                   |         |        |       |          |                 |
|     |                   |         |        |       |          |                 |
|     |                   |         |        |       |          |                 |
|     |                   |         |        |       |          |                 |
|     |                   |         |        |       |          |                 |
|-------------------------|---------|--------|-------|----------|                 |
|TOTAL or CARRIED OVER /  |         |        |       |    /     |                 |
|TOTAL OU A REPORTER      |         |        |       |   /      |                 |
-----------------------------------------------------------------------------------

---------
|Stamp /|
|Timbre |
---------

     --------------------------------
     <*> Commercial value in country / customs territory of issue  and
in its currency,  unless stated differently.  / <*> Valeur commerciale
dans le pays / territoire douanier d`emission et dans sa monnaie, sauf
indication contraire.
     <**> Show country of origin if different from country  /  customs
territory  of  issue  of the Carnet,  using ISO country codes.  / <**>
Indiquer le pays d`origine s`il est different  du  pays  /  territoire
douanier d`emission du carnet,  en utilisant le code international des
pays ISO.

                                                   лист зеленого цвета


                                                         ---------
A.T.A. CARNET / CARNET A.T.A.  CARNET N <*> / Carnet No. |       |
                                                         ---------

              ----------------------------------------------------------------------------
FOR USE BY    |E |E         |1. The goods described                                      |
CUSTOMS OF    |X |X         |   in the General List under item No.(s) .................. |
COUNTRY /     |P |P         |   Les marchandises enumerees a la liste                    |
CUSTOMS       |O |O         |   generale sous le(s) n(s) ........... have been exported  |
TERRITORY OF  |R |R         |                                         ont ete exportees  |
TEMPORARY     |T |T         |------------------------------------------------------------|
EXPORTATION   |A |A         |                                    ------------------------|
RESERVE A LA  |T |T         |2. Final date for duty-free         |                      ||
DOUANE DU PAYS|I |I         |   re-importation <*> /             |year / month /   day /||
/ TERRITOIRE  |O |O         |   Date limite pour la              |                      ||
DOUANIER      |N |N         |   reimportation en franchise <*>   |/   .       .    .  . ||
D`EXPORTATION |  |          |------------------------------------------------------------|
TEMPORAIRE    |  |          |3. Other remarks <*> / Autres    |7.                        |
              |  |          |   mentions <*> .................|                          |
              |  |          |   ..............................|                          |
              |  |          |   ..............................|                          |
              |-------------|---------------------------------|                          |
              |Counterfoil /|4.          |5.    |6.           |                          |
              |Souche No. / | .......... |......|..../..../...|                          |
              |No.          |   Customs  |Place |Date (year / |                          |
              |             |   Office   | Lieu |month / day) |................ ---------|
              |             |   Bureau   |      |Date (annee /| Signature and   |       ||
              |             |  de douane |      |mois / jour) |     Stamp       |       ||
              |             |            |      |             | Signature et    |       ||
              |             |            |      |             |     Timbre      ---------|
              ----------------------------------------------------------------------------

              ----------------------------------------------------------------------------
              |R |R         |1. The goods described                                      |
              |E |E         |   in the General List under item No.(s) ...................|
              |I |I         |   Les marchandises enumerees a la liste                    |
              |M |M         |   generale sous le(s) n(s)                                 |
              |P |P         |   .........................................................|
              |O |O         |                                                            |
              |R |R         |   which were temporarity exported under cover of           |
              |T |T         |   exportation voucher(s) No.(s) ............ of this Carnet|
              |A |A         |   have been re-imported <*>                                |
              |T |T         |                                                            |
              |I |I         |   exportees temporairement sous couvert du (des) volet(s)  |
              |O |O         |   d`exportation N(s) ........... du present carnet ont     |
              |N |N         |   ete reimportees <*>                                      |
              |  |          |------------------------------------------------------------|
              |  |          |2. Other remarks <*> / Autres    |6.                        |
              |  |          |   mentions <*> .................|                          |
              |  |          |   ..............................|                          |
              |  |          |   ..............................|                          |
              |-------------|---------------------------------|                          |
              |Counterfoil /|3.          |4.    |5.           |                          |
              |Souche No. / | .......... |......|..../..../...|                          |
              |No.          |   Customs  |Place |Date (year / |                          |
              |             |   Office   |Lieu  |month / day) |................ ---------|
              |             |   Bureau   |      |Date (annee /| Signature and   |       ||
              |             |  de douane |      |mois / jour) |     Stamp       |       ||
              |             |            |      |             | Signature et    |       ||
              |             |            |      |             |     Timbre      ---------|
              ----------------------------------------------------------------------------
              ----------------------------------------------------------------------------

              ----------------------------------------------------------------------------
              |E |E         |1. The goods described                                      |
              |X |X         |   in the General List under item No.(s) .................. |
              |P |P         |   Les marchandises enumerees a la liste                    |
              |O |O         |   generale sous le(s) n(s) ........... have been exported  |
              |R |R         |                                         ont ete exportees  |
              |T |T         |------------------------------------------------------------|
              |A |A         |                                ----------------------------|
              |T |T         |2. Final date for duty-free     |                          ||
              |I |I         |   re-importation <*> /         |year / month / day  /    /||
              |O |O         |   Date limite pour la          |annee/ mois /  jour/    / ||
              |N |N         |   reimportation en franchise   |                          ||
              |  |          |------------------------------------------------------------|
              |  |          |3. Other remarks <*> / Autres    |7.                        |
              |  |          |   mentions <*> .................|                          |
              |  |          |   ..............................|                          |
              |  |          |   ..............................|                          |
              |-------------|---------------------------------|                          |
              |Counterfoil /|4.          |5.    |6.           |                          |
              |Souche No. / | .......... |......|..../..../...|                          |
              |No.          |   Customs  |Place |Date (year / |                          |
              |             |   Office   |Lieu  |month / day) |................ ---------|
              |             |   Bureau   |      |Date (annee /| Signature and   |       ||
              |             |  de douane |      |mois / jour) |     Stamp       |       ||
              |             |            |      |             | Signature et    |       ||
              |             |            |      |             |     Timbre      ---------|
              ----------------------------------------------------------------------------

              ----------------------------------------------------------------------------
              |R |R         |1. The goods described                                      |
              |E |E         |   in the General List under item No.(s) ...................|
              |I |I         |   Les marchandises enumerees a la liste                    |
              |M |M         |   generale sous le(s) n(s)                                 |
              |P |P         |   .........................................................|
              |O |O         |                                                            |
              |R |R         |   which were temporarity exported under cover of           |
              |T |T         |   exportation voucher(s) No.(s) ............ of this Carnet|
              |A |A         |                                   have been re-imported <*>|
              |T |T         |                                                            |
              |I |I         |   exportees temporairement sous couvert du (des) volet(s)  |
              |O |O         |   d`exportation N(s) ........... du present carnet ont     |
              |N |N         |                                  ete reimportees <*>       |
              |  |          |------------------------------------------------------------|
              |  |          |2. Other remarks <*> / Autres    |6.                        |
              |  |          |   mentions <*> .................|                          |
              |  |          |   ..............................|                          |
              |  |          |   ..............................|                          |
              |-------------|---------------------------------|                          |
              |Counterfoil /|3.          |4.    |5.           |                          |
              |Souche No. / | .......... |......|..../..../...|                          |
              |No.          |   Customs  |Place |Date (year / |                          |
              |             |   Office   |Lieu  |month / day) |................ ---------|
              |             |   Bureau   |      |Date (annee /| Signature and   |       ||
              |             |  de douane |      |mois / jour) |     Stamp       |       ||
              |             |            |      |             | Signature et    |       ||
              |             |            |      |             |     Timbre      ---------|
              ----------------------------------------------------------------------------

     --------------------------------
     <*> If applicable / <*> S`il y a lieu.

     DO NOT REMOVE FROM THE CARNET / NE PAS DETACHER DU CARNET

                                                    лист желтого цвета


                                                         ---------
A.T.A. CARNET / CARNET A.T.A.  CARNET N <*> / Carnet No. |       |
                                                         ---------

            ----------------------------------------------------------------------------
FOR USE BY  |T |T         |   Clearance for transit /                                  |
CUSTOMS OF  |R |R         |   Dedouanement pour je transit                             |
COUNTRY /   |A |A         |1. The goods described in the                               |
CUSTOMS     |N |N         |   General List under Item                                  |
TERRITORY OF|S |S         |   No.(s) ..................................................|
TRANSIT     |I |I         |   Les marchandises enumerees a                             |
RESERVE A LA|T |T         |   la liste generale sous le(s)                             |
DOUANE DU   |  |          |   N(s)                                                     |
PAYS /      |  |          |   have been despatched in                                  |
TERRITOIRE  |  |          |   transit to the Customs                                   |
DOUANER DE  |  |          |   Office at ...............................................|
TRANSIT     |  |          |   ont ete expediees en                                     |
            |  |          |   transit sur le bureau de                                 |
            |  |          |   douane de                                                |
            |  |          |2. Final date for                                           |
            |  |          |   re-exportation / production                              |
            |  |          |   to the Customs of goods <*>                              |
            |  |          |   Date limite pour la                                      |
            |  |          |   reexportation / la         ------------------------------|
            |  |          |   representation a la douane |                            ||
            |  |          |   des marchandises <*>       |year   / month / day   /   /||
            |  |          |3. Registered under reference |annee /  mois /  jour /   / ||
            |  |          |   No. <*> / Enregistre sous  |                            ||
            |  |          |   le n <**>                  ------------------------------|
            |  |          |   ............................. ---------------------------|
            |  |          |---------------------------------|7.                        |
            |  |          |4.          |5.    |6.           |                          |
            |  |          | .......... |......|..../..../...|                          |
            |  |          |   Customs  |Place |Date (year / |                          |
            |  |          |   Office   |Lieu  |month / day) |................ ---------|
            |  |          |   Bureau   |      |Date (annee /| Signature and   |       ||
            |  |          |  de douane |      |mois / jour) |     Stamp       |       ||
            |  |          |            |      |             | Signature et    |       ||
            |  |          |            |      |             |     Timbre      ---------|
            |  |          |------------------------------------------------------------|
            |  |          |   Certificate of discharge by the Customs Office of        |
            |  |          |   destination / Certificat de decharge du bureau de        |
            |  |          |   destination                                              |
            |  |          |1. The goods specified in paragraph 1 above have been       |
            |  |          |   re-exported / produced <*>                               |
            |  |          |   Les marchandises visees au paragraphe                    |
            |  |          |   1 ci-dessua ont ete reexportees /                        |
            |  |          |   representees <*>                                         |
            |  |          |2. Other remarks <*> / Autres mentions <*> .................|
            |  |          |   ............................. ---------------------------|
            |-------------|---------------------------------|6.                        |
            |Counterfoil /|3.          |4.    |5.           |                          |
            |Souche No. / | .......... |......|..../..../...|                          |
            |No.          |   Customs  |Place |Date (year / |                          |
            |             |   Office   |Lieu  |month / day) |................ ---------|
            |             |   Bureau   |      |Date (annee /| Signature and   |       ||
            |             |  de douane |      |mois / jour) |     Stamp       |       ||
            |             |            |      |             | Signature et    |       ||
            |             |            |      |             |     Timbre      ---------|
            ----------------------------------------------------------------------------

            ----------------------------------------------------------------------------
            |T |T         |   Clearance for transit /                                  |
            |R |R         |   Dedouanement pour le transit                             |
            |A |A         |1. The goods described in the                               |
            |N |N         |   General List under item                                  |
            |S |S         |   No.(s) ..................................................|
            |I |I         |   Les marchandises enumerees a                             |
            |T |T         |   la liste generale sous le(s)                             |
            |  |          |   N(s)                                                     |
            |  |          |   have been despatched in                                  |
            |  |          |   transit to the Customs                                   |
            |  |          |   Office at ...............................................|
            |  |          |   ont ete expediees en                                     |
            |  |          |   transit sur le bureau de                                 |
            |  |          |   douane de                                                |
            |  |          |2. Final date for                                           |
            |  |          |   re-exportation / production                              |
            |  |          |   to the Customs of goods <*>                              |
            |  |          |   Date limite pour la                                      |
            |  |          |   reexportation / la         ------------------------------|
            |  |          |   representation a la douane |                            ||
            |  |          |   des marchandises <*>       |year   / month / day   /   /||
            |  |          |3. Registered under reference |annee /  mois /  jour /   / ||
            |  |          |   No. <*> / Enregistre sous  |                            ||
            |  |          |   le n <**>                  ------------------------------|
            |  |          |   ............................. ---------------------------|
            |  |          |---------------------------------|7.                        |
            |  |          |4.          |5.    |6.           |                          |
            |  |          | .......... |......|..../..../...|                          |
            |  |          |   Customs  |Place |Date (year / |                          |
            |  |          |   Office   |Lieu  |month / day) |................ ---------|
            |  |          |   Bureau   |      |Date (annee /| Signature and   |       ||
            |  |          |  de douane |      |mois / jour) |     Stamp       |       ||
            |  |          |            |      |             | Signature et    |       ||
            |  |          |            |      |             |     Timbre      ---------|
            |  |          |------------------------------------------------------------|
            |  |          |   Certificate of discharge by the Customs Office of        |
            |  |          |   destination / Certificat de decharge du bureau de        |
            |  |          |   destination                                              |
            |  |          |1. The goods specified in paragraph 1 above have been       |
            |  |          |   re-exported / produced <*>                               |
            |  |          |   Les marchandises visees au paragraphe                    |
            |  |          |   1 ci-dessua ont ete reexportees /                        |
            |  |          |   representees <*>                                         |
            |  |          |2. Other remarks <*> / Autres mentions <*> .................|
            |  |          |   ............................. ---------------------------|
            |-------------|---------------------------------|6.                        |
            |Counterfoil /|3.          |4.    |5.           |                          |
            |Souche No. / | .......... |......|..../..../...|                          |
            |No.          |   Customs  |Place |Date (year / |                          |
            |             |   Office   |Lieu  |month / day) |................ ---------|
            |             |   Bureau   |      |Date (annee /| Signature and   |       ||
            |             |  de douane |      |mois / jour) |     Stamp       |       ||
            |             |            |      |             | Signature et    |       ||
            |             |            |      |             |     Timbre      ---------|
            ----------------------------------------------------------------------------
             ---------------------------------------------------------------------------
            ----------------------------------------------------------------------------
            |T |T         |   Clearance for transit /                                  |
            |R |R         |   Dedouanement pour le transit                             |
            |A |A         |1. The goods described in the                               |
            |N |N         |   General List under item                                  |
            |S |S         |   No.(s) ..................................................|
            |I |I         |   Les marchandises enumerees a                             |
            |T |T         |   la liste generale sous le(s)                             |
            |  |          |   N(s)                                                     |
            |  |          |   have been despatched in                                  |
            |  |          |   transit to the Customs                                   |
            |  |          |   Office at ...............................................|
            |  |          |   ont ete expediees en                                     |
            |  |          |   transit sur le bureau de                                 |
            |  |          |   douane de                                                |
            |  |          |2. Final date for                                           |
            |  |          |   re-exportation / production                              |
            |  |          |   to the Customs of goods <*>                              |
            |  |          |   Date limite pour la                                      |
            |  |          |   reexportation / la         ------------------------------|
            |  |          |   representation a la douane |                            ||
            |  |          |   des marchandises <*>       |year   / month / day  /    /||
            |  |          |3. Registered under reference |annee /  mois /  jour/    / ||
            |  |          |   No. <*> / Enregistre sous  |                            ||
            |  |          |   le n <*>                   ------------------------------|
            |  |          |   ............................. ---------------------------|
            |  |          |---------------------------------|7.                        |
            |  |          |4.          |5.    |6.           |                          |
            |  |          | .......... |......|.............|                          |
            |  |          |   Customs  |Place |Date (year / |                          |
            |  |          |   Office   |Lieu  |month / day) |................ ---------|
            |  |          |   Bureau   |      |Date (annee /| Signature and   |       ||
            |  |          |  de douane |      |mois / jour) |     Stamp       |       ||
            |  |          |            |      |             | Signature et    |       ||
            |  |          |            |      |             |     Timbre      ---------|
            |  |          |------------------------------------------------------------|
            |  |          |   Certificate of discharge by the Customs Office of        |
            |  |          |   destination / Certificat de decharge du bureau de        |
            |  |          |   destination                                              |
            |  |          |1. The goods specified in paragraph 1 above have been       |
            |  |          |   re-exported / produced <*>                               |
            |  |          |   Les marchandises visees au paragraphe                    |
            |  |          |   1 ci-dessus ont ete reexportees /                        |
            |  |          |   representees <*>                                         |
            |  |          |2. Other remarks <*> / Autres mentions <*> .................|
            |  |          |   ............................. ---------------------------|
            |-------------|---------------------------------|6.                        |
            |Counterfoil /|3.          |4.    |5.           |                          |
            |Souche No. / | .......... |......|.............|                          |
            |No.          |   Customs  |Place |Date (year / |                          |
            |             |   Office   |Lieu  |month / day) |................ ---------|
            |             |   Bureau   |      |Date (annee /| Signature and   |       ||
            |             |  de douane |      |mois / jour) |     Stamp       |       ||
            |             |            |      |             | Signature et    |       ||
            |             |            |      |             |     Timbre      ---------|
            ----------------------------------------------------------------------------

            ----------------------------------------------------------------------------
            |T |T         |   Clearance for transit /                                  |
            |R |R         |   Dedouanement pour le transit                             |
            |A |A         |1. The goods described in the                               |
            |N |N         |   General List under item                                  |
            |S |S         |   No.(s) ..................................................|
            |I |I         |   Les marchandises enumerees a                             |
            |T |T         |   la liste generale sous le(s)                             |
            |  |          |   N(s)                                                     |
            |  |          |   have been despatched in                                  |
            |  |          |   transit to the Customs                                   |
            |  |          |   Office at ...............................................|
            |  |          |   ont ete expediees en                                     |
            |  |          |   transit sur le bureau de                                 |
            |  |          |   douane de                                                |
            |  |          |2. Final date for                                           |
            |  |          |   re-exportation / production                              |
            |  |          |   to the Customs of goods <*>                              |
            |  |          |   Date limite pour la                                      |
            |  |          |   reexportation / la         ------------------------------|
            |  |          |   representation a la douane |                            ||
            |  |          |   des marchandises <*>       |year   / month / day  /    /||
            |  |          |3. Registered under reference |annee /  mois /  jour/    / ||
            |  |          |   No. <*> / Enregistre sous  |                            ||
            |  |          |   le n <*>                   ------------------------------|
            |  |          |   ............................. ---------------------------|
            |  |          |---------------------------------|7.                        |
            |  |          |4.          |5.    |6.           |                          |
            |  |          | .......... |......|.............|                          |
            |  |          |   Customs  |Place |Date (year / |                          |
            |  |          |   Office   |Lieu  |month / day) |................ ---------|
            |  |          |   Bureau   |      |Date (annee /| Signature and   |       ||
            |  |          |  de douane |      |mois / jour) |     Stamp       |       ||
            |  |          |            |      |             | Signature et    |       ||
            |  |          |            |      |             |     Timbre      ---------|
            |  |          |------------------------------------------------------------|
            |  |          |   Certificate of discharge by the Customs Office of        |
            |  |          |   destination / Certificat de decharge du bureau de        |
            |  |          |   destination                                              |
            |  |          |1. The goods specified in paragraph 1 above have been       |
            |  |          |   re-exported / produced <*>                               |
            |  |          |   Les marchandises visees au paragraphe                    |
            |  |          |   1 ci-dessus ont ete reexportees /                        |
            |  |          |   representees <*>                                         |
            |  |          |2. Other remarks <*> / Autres mentions <*> .................|
            |  |          |   ............................. ---------------------------|
            |-------------|---------------------------------|6.                        |
            |Counterfoil /|3.          |4.    |5.           |                          |
            |Souche No. / | .......... |......|.............|                          |
            |No.          |   Customs  |Place |Date (year / |                          |
            |             |   Office   |Lieu  |month / day) |................ ---------|
            |             |   Bureau   |      |Date (annee /| Signature and   |       ||
            |             |  de douane |      |mois / jour) |     Stamp       |       ||
            |             |            |      |             | Signature et    |       ||
            |             |            |      |             |     Timbre      ---------|
            ----------------------------------------------------------------------------

     --------------------------------
     <*> If applicable / <*> S`il y a lieu.

     DO NOT REMOVE FROM THE CARNET / NE PAS DETACHER DU CARNET

                                                   лист голубого цвета


                                                         ---------
A.T.A. CARNET / CARNET A.T.A.  CARNET N <*> / Carnet No. |       |
                                                         ---------

             ----------------------------------------------------------------------------
FOR USE BY   |I |I         |1. The goods described                                      |
CUSTOMS OF   |M |M         |   in the General List under item No.(s) .................. |
COUNTRY /    |P |P         |   Les merchandises enumerees a la liste                    |
CUSTOMS      |O |O         |   generale sous le(s) n(s) ........... have been           |
TERRITORY OF |R |R         |                                        temporarily imported|
TEMPORARY    |T |T         |                                        ont ete importees   |
IMPORTATION  |A |A         |                                        temporairement      |
RESERVE A LA |T |T         |------------------------------------------------------------|
DOUANE DU    |I |I         |                                    ------------------------|
PAYS /       |O |O         |2. Final date for re-exportation /  |                      ||
TERRITOIRE   |N |N         |   production to the Customs of     |year / month /  day //||
DOUANIER     |  |          |   goods <*> /                      |                      ||
D`IMPORTATION|  |          |   Date limite pour la reexportation|annee / mois / jour //||
TEMPORAIRE   |  |          |   / la representation a la douane, |                      ||
             |  |          |   des marchandises <*>             |                      ||
             |  |          |------------------------------------------------------------|
             |  |          |3. Registered under reference    |8.                        |
             |  |          |   No. <*> / Enregistre sous le  |                          |
             |  |          |   n <*> ........................|                          |
             |  |          |---------------------------------|                          |
             |  |          |4. Other remarks / Autres        |                          |
             |  |          |   mentions <*> .................|                          |
             |  |          |   ..............................|                          |
             |  |          |   ..............................|                          |
             |-------------|---------------------------------|                          |
             |Counterfoil /|4.          |5.    |6.           |                          |
             |Souche No. / | .......... |......|.............|                          |
             |No.          |   Customs  |Place |Date (year / |                          |
             |             |   Office   |Lieu  |month / day) |................ ---------|
             |             |   Bureau   |      |Date (annee /| Signature and   |       ||
             |             |  de douane |      |mois / jour) |     Stamp       |       ||
             |             |            |      |             | Signature et    |       ||
             |             |            |      |             |     Timbre      ---------|
             ----------------------------------------------------------------------------

             ----------------------------------------------------------------------------
             |R |R         |1. The goods described                                      |
             |E |E         |   in the General List under item No.(s) ...................|
             |E |E         |   Les marchandises enumerees a la liste                    |
             |X |X         |   generale sous le(s) n(s)                                 |
             |P |P         |   .........................................................|
             |O |O         |                                                            |
             |R |R         |   which were temporarily imported under cover of           |
             |T |T         |   importation voucher(s) No.(s) ...........................|
             |A |A         |   importees temporairement sous couvert du (des) volet(s)  |
             |T |T         |   d`importation N(s)                                       |
             |I |I         |   of this Carnet have been re-exported <*> / du present    |
             |O |O         |   carnet, ont ete reexportees <*>                          |
             |N |N         |------------------------------------------------------------|
             |  |          |2. Action taken in respect of goods produced but not        |
             |  |          |   reexported <*> ..........................................|
             |  |          |   Mesures prises a l`egard des marchandises representees   |
             |  |          |   mais non reexportees <*>                                 |
             |  |          |   .........................................................|
             |  |          |------------------------------------------------------------|
             |  |          |3. Action taken in respect of    |8.                        |
             |  |          |   goods not produced and not    |                          |
             |  |          |   intended for later            |                          |
             |  |          |   reexportation <*>             |                          |
             |  |          |   Mesures prises a l`egard      |                          |
             |  |          |   des marchandises non          |                          |
             |  |          |   representees et non           |                          |
             |  |          |   destinees a une               |                          |
             |  |          |   rexportation ulterieure <*>   |                          |
             |  |          |   ..............................|                          |
             |  |          |   ..............................|                          |
             |-------------|---------------------------------|                          |
             |Counterfoil /|4. Registered under reference    |                          |
             |Souche No. / |   No. / Enregistre sous le N    |                          |
             |No.          |---------------------------------|                          |
             |             |5.          |6.    |7.           |                          |
             |             |            |......|.............|                          |
             |             |            |Place |Date (year / |                          |
             |             |            |Lieu  |month / day) |................ ---------|
             |             |            |      |Date (annee /| Signature and   |       ||
             |             |            |      |mois / jour) |     Stamp       |       ||
             |             |            |      |             | Signature et    |       ||
             |             |            |      |             |     Timbre      ---------|
             ----------------------------------------------------------------------------

             ----------------------------------------------------------------------------

             ----------------------------------------------------------------------------
             |I |I         |1. The goods described                                      |
             |M |M         |   in the General List under item No.(s) .................. |
             |P |P         |   Les merchandises enumerees a la liste                    |
             |O |O         |   generale sous le(s) n(s) ............ have been tempora- |
             |R |R         |   rely imported ...........................................|
             |T |T         |                      ont ete importees temporairement      |
             |A |A         |------------------------------------------------------------|
             |T |T         |                                    ------------------------|
             |I |I         |2. Final date for re-exportation /  |                      ||
             |O |O         |   production to the Customs of     |year / month /  day //||
             |N |N         |   goods <*> /                      |                      ||
             |  |          |   Date limite pour la reexportation|annee / mois / jour //||
             |  |          |   / la representation a la douane, |                      ||
             |  |          |   des marchandises <*>             |                      ||
             |  |          |------------------------------------------------------------|
             |  |          |3. Registered under reference    |8.                        |
             |  |          |   No. <*> / Enregistre sous le  |                          |
             |  |          |   n <**> .......................|                          |
             |  |          |---------------------------------|                          |
             |  |          |6. Other remarks <*>/ Autres     |                          |
             |  |          |   mentions <*> .................|                          |
             |  |          |   ..............................|                          |
             |  |          |   ..............................|                          |
             |-------------|---------------------------------|                          |
             |Counterfoil /|5.          |6.    |7.           |                          |
             |Souche No. / | .......... |......|.............|                          |
             |No.          |   Customs  |Place |Date (year / |                          |
             |             |   Office   |Lieu  |month / day) |................ ---------|
             |             |   Bureau   |      |Date (annee /| Signature and   |       ||
             |             |  de douane |      |mois / jour) |     Stamp       |       ||
             |             |            |      |             | Signature et    |       ||
             |             |            |      |             |     Timbre      ---------|
             ----------------------------------------------------------------------------

             ----------------------------------------------------------------------------
             |R |R         |1. The goods described                                      |
             |E |E         |   in the General List under item No.(s) ...................|
             |E |E         |   Les marchandises enumerees a la liste                    |
             |X |X         |   generale sous le(s) n(s)                                 |
             |P |P         |   .........................................................|
             |O |O         |                                                            |
             |R |R         |   which were temporarily imported under cover of           |
             |T |T         |   importation voucher(s) No.(s) ...........................|
             |A |A         |   importees temporairement sous couvert du (des) volet(s)  |
             |T |T         |   d`importalion N(s) of this Carnes have been reexported   |
             |I |I         |   <*> J du present camet, ont ele reexportees <*>          |
             |O |O         |------------------------------------------------------------|
             |N |N         |2. Action taken in respect of goods produced but not        |
             |  |          |   reexported <*> ..........................................|
             |  |          |   Mesures prises a l`egard des marchandises representees   |
             |  |          |   mais non reexportees <*>                                 |
             |  |          |   .........................................................|
             |  |          |------------------------------------------------------------|
             |  |          |3. Action taken in respect of    |8.                        |
             |  |          |   goods not produced and not    |                          |
             |  |          |   intended for later            |                          |
             |  |          |   reexportation <*>             |                          |
             |  |          |   Mesures prises a l`egard      |                          |
             |  |          |   des marchandises non          |                          |
             |  |          |   representees et non           |                          |
             |  |          |   destinees a une               |                          |
             |  |          |   reexportation ulterieure <*>  |                          |
             |  |          |   ..............................|                          |
             |  |          |   ..............................|                          |
             |-------------|---------------------------------|                          |
             |Counterfoil /|4. Registered under reference    |                          |
             |Souche No. / |   No / Enregistre sous le N <*> |                          |
             |No.          |---------------------------------|                          |
             |             |5.          |6.    |7.           |                          |
             |             | .......... |......|.............|                          |
             |             |   Customs  |Place |Date (year / |                          |
             |             |   Office   |Lieu  |month / day) |................ ---------|
             |             |   Bureau   |      |Date (annee /| Signature and   |       ||
             |             |  de douane |      |mois / jour) |     Stamp       |       ||
             |             |            |      |             | Signature et    |       ||
             |             |            |      |             |     Timbre      ---------|
             ----------------------------------------------------------------------------

     --------------------------------
     <*> If applicable / <*> S`il y a lieu.

     NO NOT REMOVE FROM THE CARNET / NE PAS DETACHER DU CARNET

                                                     лист белого цвета


А.Т.А. CARNET                                            CARNET A.T.A.

------------------------------------------------------------------
|E|E|A. HOLDER AND ADDRESS /    |FOR ISSUING ASSOCIATION USE /   |
|X|X|Titulaire et adresse       |Reserve а l`association         |
|P|P|                           |emettrice                       |
|O|O|                           |                                |
|R|R|                           |G. EXPORTATION VOUCHER N .......|
|T|T|                           |   Volet d`exportation n        |
|A|A|                           |--------------------------------|
|T|T|                           |a) CARNET N     ----------------|
|I|I|                           |   Carnet n     |              ||
|O|O|                           |                ----------------|
|N|N|---------------------------|--------------------------------|
| | |B. REPRESENTED BY <*> /    |b) ISSUED BY / Delivre par      |
| | |Represente par <*>         |                                |
| | |                           |                                |
| | |                           |                                |
| | |---------------------------|--------------------------------|
| | |C. INTENDED USE OF GOODS / |c) VALID UNTIL / Valable        |
| | |Utilisation prevue des     |jusqu`au                        |
| | |marchandises               |........../........../..........|
| | |                           |  year  month  day (inclusive)  |
| | |                           |  annee mois   jour (inclus)    |
----|---------------------------|--------------------------------|
    |D. MEANS OF TRANSPORT <*> /|    FOR CUSTOMS USE ONLY /      |
    |Moyens de transport <*>    |     Reserve a la douane        |
    |                           |                                |
    |                           |  H. CLEARANCE ON EXPORTATION / |
    |                           |  Dedouanement a l`exportation  |
    |                           |                                |
    |                           |a) The goods referred to in the |
    |                           |above declaration have been     |
    |                           |exported / Les marchandises     |
    |                           |faisant t`objet de la           |
    |                           |declaration ci-contre ont ete   |
    |                           |exportees.                      |
    |---------------------------|                                |
    |E. PACKAGING DETAILS       |b) Final date for duty - free   |
    |(Number, Kind, Marks,      |reimportation / Date limite pour|
    |etc.) <*> / Detail         |la reimportation en franchise:  |
    |d`emballage (nombre,       |......... / ........ / .........|
    |nature, marques, etc.) <*> |  year  month  day              |
    |                           |  annee mois   jour             |
    |---------------------------|                                |
    |F. TEMPORARY EXPORTATION   |c) This voucher must be         |
    |DECLARATION / Declaration  |forwarded to the Customs Office |
    |d`exportation temporaire   |at: <*>; / Le present volet     |
    |                           |devra etre transmis au bureau de|
    |                           |douane de: <*>;                 |
    |                           |................................|
    |                           |                                |
    |                           |d) Other remarks: <*>; / Autres |
    |                           |mentions: <*>;                  |
    |I, duly authorised: / Je   |                                |
    |soussigne, dument autorise:|                                |
    |                           |                                |
    |a) declare that I am       |                                |
    |temporarily exporting the  |                                |
    |goods enumerated in the    |                                |
    |list overleaf and described|                                |
    |in the General List under  |                                |
    |item No.(s) / declare      |At / A ........................ |
    |exporter temporairement les|         Customs Office /       |
    |marchandises enumerees a la|         Bureau de douane       |
    |liste figurant au verso et |                                |
    |reprises a la liste        |                                |
    |generale des marchandises  |                                |
    |sous le(s) N(s).           |                                |
    |...........................|                                |
    |...........................|                                |
    |b) undertake to re-import  |                                |
    |the goods within the period|                                |
    |stipulated by the Customs  |                                |
    |Office or regularize their |                                |
    |status in accordance with  |                                |
    |the laws and regulations of|                     ---------  |
    |the country / Customs      |                     |       |  |
    |territory of importation / |                     |       |  |
    |m`engage a reimporter ces  |                     |       |  |
    |marchandises dans le delai |                     ---------  |
    |fixe par le bureau de      |                                |
    |douane ou a regulariser    |..../..../.... ................ |
    |leur situation selon les   |Date (year /    Signature and   |
    |lois et reglements du pays |month / day)        Stamp       |
    |/ territoire douanier      |Date (annee /   Signature et    |
    |d`importation.             |mois / jour)       Timbre       |
    |                           ---------------------------------|
    |c) confirm that the         Place ........... Date (year /  |
    |information given is true   month / day) ... / .. / ....... |
    |and complete / certifie     Lieu Date (annee / mois / jour) |
    |sinceres et completes les                                   |
    |indications portees sur le  Name .......................... |
    |present volet.              Nom                             |
    |                                                            |
    |                            Signature X ................. X |
    |                            Signature                       |
    --------------------------------------------------------------

     --------------------------------
     <*> If applicable / <*> S`il y a lieu.

                                                    лист желтого цвета


A.T.A. CARNET                                            CARNET A.T.A.

                    GENERAL LIST / LISTE GENERALE

                                             оборотная сторона листа 8

----------------------------------------------------------------------------------
|Item | Trade description | Number  |Weight  |Value /|<**>     |For Customs Use /|
|No / |of goods and marks |   of    |  or    |Valeur |Country  |  Reserve a la   |
|N    |    and numbers,   |Pieces / |Volume /|       |of       |     douane      |
|d`   |      if any /     | Nombre  | Poids  |       |origin / |  Identification |
|ordre|    Designation    |   de    |   ou   |       |<**>     |     marks /     |
|     |  commerciale des  | Pieces  | Volume |       |Pays     |     Marques     |
|     |  marchandises et, |         |        |       |d`origine|d`identification |
|     |  le cas echeant,  |         |        |       |         |                 |
|     |marques et numeros |         |        |       |         |                 |
|-----|-------------------|---------|--------|-------|---------|-----------------|
|  1  |         2         |    3    |    4   |   5   |    6    |         7       |
|-----|-------------------|---------|--------|-------|---------|-----------------|
|     |                   |         |        |       |         |                 |
|     |                   |         |        |       |         |                 |
|     |                   |         |        |       |         |                 |
|     |                   |         |        |       |         |                 |
|     |                   |         |        |       |         |                 |
|     |                   |         |        |       |         |                 |
|-------------------------|---------|--------|-------|---------|                 |
|TOTAL or CARRIED OVER /  |         |        |       |    /    |                 |
|TOTAL OU A REPORTER      |         |        |       |   /     |                 |
---------------------------------------------------------------------------------

     --------------------------------
     <*> Commercial  value in country / customs territory of issue and
in its currency,  unless stated differently.  / <*> Valeur commerciale
dans le pays / territoire douanier d`emission et dans sa monnaie, sauf
indication contraire.
     <**> Show  country of origine if different from country / customs
territory of issue of the Garnet,  using ISO  country  codes.  /  <**>
Indiquer  le  pays  d`origine  s`il est different du pays / territoire
douanier d`emission du carnet,  en utilisant le code international des
pays ISO.

                                                    лист желтого цвета


А.Т.А. CARNET                                            CARNET A.T.A.

------------------------------------------------------------------
|R|R|A. HOLDER AND ADDRESS /    |FOR ISSUING ASSOCIATION USE /   |
|E|E|Titulaire et adresse       |Reserve а l`association         |
|I|I|                           |emettrice                       |
|M|M|                           |                                |
|P|P|                           |G. REIMPORTATION VOUCHER N .....|
|O|O|                           |   Volet de reimportation n     |
|R|R|                           |--------------------------------|
|T|T|                           |a) CARNET N /   ----------------|
|A|A|                           |   Carnet n     |              ||
|T|T|                           |                ----------------|
|I|I|---------------------------|--------------------------------|
|O|O|B. REPRESENTED BY <*>.     |b) ISSUED BY / Delivre par      |
|N|N|Represente par <*>         |                                |
| | |                           |                                |
| | |                           |                                |
| | |---------------------------|--------------------------------|
| | |C. INTENDED USE OF GOODS / |c) VALID UNTIL / Valable        |
| | |Utilisation prevue des     |jusqu`au                        |
| | |marchandises               |........../........../..........|
| | |                           |  year  month  day (inclusive)  |
| | |                           |  annee mois   jour (inclus)    |
----|---------------------------|--------------------------------|
    |D. MEANS OF TRANSPORT <*> /|    FOR CUSTOMS USE ONLY /      |
    |Moyens de transport <*>    |     Reserve a la douane        |
    |                           |                                |
    |                           |H. CLEARANCE ON RE-IMPORTATION /|
    |                           |   Dedouanement a la            |
    |                           |   reimportation                |
    |                           |                                |
    |                           |a) The goods referred to in     |
    |                           |paragraph F. a) and b) of the   |
    |                           |holder`s declaration have been  |
    |                           |re-imported. / Les marchandises |
    |                           |visees au paragraphe F. a) et   |
    |                           |b) de la declaration ci-contre  |
    |                           |ont ete reimportees.            |
    |---------------------------|                                |
    |E. PACKAGING DETAILS       |b) This voucher must be         |
    |(Number, Kind, Marks,      |forwarded to the Customs Office |
    |etc.) <*> / Detail         |at <*> / Le present volet devra |
    |d`emballage (nombre,       |etre transmis au bureau de      |
    |nature, marques, etc.) <*> |douane de <*>                   |
    |---------------------------|                                |
    |F. RE-IMPORTATION          |c) <*> Other remarks /          |
    |DECLARATION / Declaration  |<*> Autres mentions             |
    |de reimportation           |                                |
    |I, duly authorised: / Je   |                                |
    |soussigne, dument autorise:|                                |
    |                           |                                |
    |a) declare that the goods  |                                |
    |enumerated in the list     |                                |
    |overleaf and described in  |                                |
    |the General List under item|                                |
    |No.(s) / declare que les   |                                |
    |marchandises enumerees a la|                                |
    |liste figurant au verso et |                                |
    |reprises a la liste        |                                |
    |generale sous le(s) N(s)   |                                |
    |...........................|                                |
    |...........................|                                |
    |were temporarily exported  |                                |
    |under cover of exportation |                                |
    |voucher(s) No.(s) / ont ete|                                |
    |exportees temporairement   |                                |
    |sous le couvert du(des)    |                                |
    |volet(s) d`exportation     |                                |
    |N(s)                       |                                |
    |...........................|                                |
    |...........................|                                |
    |request duty - free        |                                |
    |re-importation of the said |                                |
    |goods / demande la         |                                |
    |reimportation en franchise |                                |
    |de ces marchandises.       |                                |
    |b) declare that the said   |At / A ........................ |
    |goods have NOT undergone   |         Customs Office /       |
    |any process abroad, except |         Bureau de douane       |
    |for those described under  |                                |
    |N(s): <*> / declare que    |                                |
    |lesdites marchandises      |                                |
    |n`ont subi aucune ouvraison|                                |
    |a l`etranger, sauf celles  |                                |
    |enumerees sous le(s) N(s)  |                                |
    |<*>                        |                                |
    |...........................|                                |
    |...........................|                                |
    |c) declare that goods of   |                     ---------  |
    |the following item N(s)    |                     |       |  |
    |have not been re-imported  |                     |       |  |
    |<*>: / declare ne pas      |                     |       |  |
    |reimporter les marchandises|                     ---------  |
    |reprises sous le(s) N(s)   |                                |
    |suivant(s) <*>:            |..../..../.... ................ |
    |...........................|Date (year /    Signature and   |
    |...........................|month / day)        Stamp       |
    |                           |Date (annee /   Signature et    |
    |                           |mois / jour)       Timbre       |
    |                           ---------------------------------|
    |d) confirm that the         Place ........... Date (year /  |
    |information given is true   month / day) ..../..../........ |
    |and complete / certifie     Lieu              Date (annee / |
    |sinceres et completes les   mois / jour)                    |
    |indications portees sur le                                  |
    |present volet.              Name .......................... |
    |                            Nom                             |
    |                                                            |
    |                            Signature X ................. X |
    |                            Signature                       |

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