Mandatory Data on the Long-term vendor declaration form:
 

(1) Country, group of countries or territory concerned:
Andorra (AD), Switzerland (CH), Turkey (TR),Albania (AL), Bosnia-Hercegovina (BA), Kosovo (XK = KO), Montenegro (ME), Macedonia (MK), Serbia (XS = RS), Algeria DZ), Egypt (EG), Faroe Islands (FO), Israel (IL), Jordan (JO), Lebanon (LB), Morocco (MA), West Bank and Gaza Strip (PS), Syria (SY), Tunisia (TN), Ceuta (XC), Melilla (XL), Georgia (GE), Moldova (MD),Ukraine (UA), Rep. of Korea (KR),Ivory Coast (CI),Chile (CL), Mexico (MX),
Andean-countries: Colombia (CO), Peru (PE), Ecuador (EC)
Cariforum: Antigua and Barbuda (AG), Bahamas (BS), Barbados (BB) , Belize (BZ), Dominica (DM),Dominican Republic (DO), Grenada (GD), Guyana (GY), Jamaica (JM), Saint Christopher and- Nevis (KN), Saint Lucia (LC),Suriname (SR), Trinidad and Tobago (TT), Saint Vincent and theGrenadines (VC).
Central-America: Costa Rica (CR), El Salvador (SV), Guatemala (GT) Honduras (HN, Nicaragua (NI), Panama (PA).
Pacific-states: Fiji (FJ), Papua New Guinea (PG).
ESA-EPA-states: Madagascar (MG), Mauritius (MU), Seychelles (SC), Zimbabwe (ZW).SADC-EPA-states: Mozambique (MZ), Botswana (BW), Lesotho (LS), Namibia (NA), South-Africa (ZA), Swaziland (SZ).
Central-Africa: Cameroon (CM).
EEA: Iceland (IS), Liechtenstein (LI), Norway (NO).
GSP*: Generalized System of Preferences – developing countries, (LDC and OBC). GSP: Armenia (AM), Bolivia (BO),   Republic of the Congo (CG), Cook Islands (CK), Colombia (CO), Costa Rica (CR), Cape Verde (CV), Ecuador (EC),Micronesia (FM), Georgia (GE), Guatemala (GT), Honduras (HN), Indonesia (ID), India (IN), Iraq (IQ), Kyrgyzstan (KG), Sri Lanka (LK), Marshall Islands (MH), Mongolia (MN), Maldives (MV), Nigeria (NG), Nicaragua (NI), Nauru (NR), Niue (NU), Panama (PA), Peru (PE), Philippines (PH), Pakistan (PK), Paraguay (PY), El Salvador (SV), Syria (SY), Thailand (TH), Tajikistan (TJ), Turkmenistan (TM), Tonga (TO), Ukraine (UA), Uzbekistan (UZ), Vietnam (VN)OCT*: - Overseas Countries and Territories of the EU member states.
MAR-ACP*: Market Access Regulation – African-Caribbean and Pacific states Ghana (GH), Cameroon (CM), Kenya.

* For an actual overview of this countries please contact the Chamber of Commerce

(2) Cumulation
Cumulation is a mechanism that allows you to consider non-originating materials used or processing carried out in another country as originating in your country or carried out in your country.To be completed, where necessary, only for goods having preferential origin status in the context of preferential trade relations with one of the countries with which pan-Euro-Mediterranean cumulation of origin is applicable:
Algeria (DZ), Egypt (EG), European Union (EU), Faroe Islands (FO), Iceland (IS), Israel (IL) Jordan (JO), Lebanon (LB), Liechtenstein (LI), Morocco (MA), Norway (NO), Tunisia (TN), Turkey (TR), West Bank andGaza Strip (PS), Switzerland (CH). 

Point of attention: As Syria did not yet sign the Pan Euro Med agreement it is not possible to fill in this country. Most common is that no cumulation happens. In case you are not sure, please leave this open

(3) Validity dates
Give the dates. The period shall not exceed 24 months from the date of issue (Attention: this is not the date on which the declaration enters into force) or 12 months if the declaration was issued retrospectively. In this case, the period might be both maximum 12 Months in the past, as 12 Months in the future as of the date of issue.

(4) Place and Date: Example: DD.MM.YYYY, London, UK

(5) Name and Position: Example: John Williams, Sales Manager

(6) Name and Address of Company: Example: Williams Motors Ltd, 1 Smith Street London, MW1, 3DR, United Kingdom

(7) Signature: Example: J. Williams