Lieu et date d' embarquement - Moyen de transport Données supplémentaires 10 Marks and numbers - Number and kind ot packages - DESCRIPTION OF GOODS 11 Quantity (') 12 FOBValue (*) Marques et numéros - Nombre et nature des colis - DÉSIGNATION DES MARCHANDISES Quantité (') Valeur fob (2) net enIndiquer le poids -weight net( 1 ) Show net weight )kg( and also quantity in the unit prescribed for category where other than 13 CERTIFICATION BY THE COMPETENT AUTHORITY - VISA DE L'AUTORITÉ COMPÉTENTE I , the undersigned, certify that the goods described above originated in the country shown in box No 6, in accordance with the provisions in force in the European Economic