受益人证明应该怎么写

beneficiaries statment that the product and packing comply with EU environmental and safety laws and contains no heavy metals and beneficiary will keep Koopman internation B.V. harmless if the item is then found to comply with EU environmenttal and safety laws including, but noe limited to, ROHS and REACH
这个受益人证明应该怎么写呢？请大师们指点

好的，谢谢！另外还有想请教下：
50 APPLICANT ：
KOOPMAN INTERNATIONAL BV
T.A.V. KIM KOPS-INKOOPADMIN
DISTELWEG 88
1031 HH AMSTERDAM

而46A中又显示CONSIGNED TO：
KOOPMAN INTERNATIONAL BV
DISTELWEG 88
1031 HH AMSTERDAM
The Netherlands.
以上应该以哪个为准呢？？