(Letterhead of company)
OWN PRODUCTION DECLARATION TO THE GOVERNMENT OF NORWAY
We hereby certify that the below listed item(s) will be exclusively used in our own production at our domestic plant(s) and will not be re-exported separately.
The item(s) will form integral parts of our products and will not have any effect on the origin of the finished products.
Contract no: Contract date:
Equipment/substance: Type:
Quantity:
Value:
Date and signature:
Stamp: