CertConnect Online - User Registration Form



NACCIMA eCertificate of Origin - User Registration/Agreement Form

Organisation Details

|1. Organisation | |

|2. Address | |

|3. City | |State | |Postcode | |

|4. Telephone | |Fax | |

|5. Email Address | |

Registration Details

|6. Contact Person | |

|7. Email Address | |

|8. Desired User ID | |

Note: This will be your User ID for access to the eC of O Online Services. Your User ID Name must be in lower case letters, between 4 and 8 characters long. We cannot guarantee that a given User ID will be available. If the chosen User ID is unavailable, we will contact you.

|9. Registered with NACCIMA for |( Yes ( No |Chamber Name: |

|Certificate of Origin? | | |

|10. NACCIMA Member No. (if | |

|applicable) | |

Note: If you do not know your NACCIMA Member No. please leave it blank.

|11. Authorised Signatory Name | |

|12. Authorised Signature | |

| | |

| | |

| | |

Note: This signature above will be embedded in your electronic certificate of origin document.

Terms and Conditions

1. NACCIMA is authorised by the existing statutes to process and issue Certification of Origin documents including ("electronic Certification of Origin").  Certification of Origin under the authority delegated by the law to NACCIMA is not a warranty or guarantee that the goods certified are acceptable for import under the laws, rules or practices of the country of their intended destination and is not intended to be relied by any person on as such a warranty or guarantee.  The electronic Certification of Origin service is provided to the Exporter on the basis that the Exporter is responsible for making their own enquiries and seeking any appropriate independent professional advice necessary regarding the acceptance or otherwise of the goods and of email Certification of Origin documents in the intended country of destination for import.  In the event that the intended country of import does not accept the goods or the electronic Certification of Origin, NACCIMA, does not accept any liability for loss, damage or personal injury, including any consequential loss, that may result, or costs that may be incurred, either directly or indirectly, as a result of any person relying on or using electronic Certification of Origin for a purpose other than that for which it is intended. 

Undertaking

I agree to the above terms and conditions.

Signed: _________________________________________

Name: __________________________________________

CAC Number: ____________________________________ (Required)

Date: ____/____/____

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