ANNEX VISupplementary provisions
ANNEX VI List of particulars to be given in the boxes of the surveillance document SURVEILLANCE DOCUMENT 1. Consignee (name, full address, country, VAT number) 2. Issue No 3. Proposed place and date of import 4. Authority responsible for issue (name, address and telephone No) 5. Declarant/representative as applicable (name and full address) 6. Country of origin/Country code 7. Country of consignment/Country code 8. Last day of validity 9. Description of goods 10. CN code and textile category 11. Quantity of kilograms (net mass) or in additional units 12. Customs value in EUR, cif at Union frontier 13. Additional remarks 14. Competent authority's endorsement Date and place (signature) (stamp) Original for the applicant Copy for the competent authorities Text of image EUROPEAN UNION SURVEILLANCE DOCUMENT 1 1. Consignee (name, full address, country, VAT No) 2. Issue No HOLDER’S COPY 3. Proposed place and date of import 4. Authority responsible for issue (name, address and telephone No) 5. Declarant/representative as applicable (name and full address) 6. Country of origin Country code 7. Country of consignment Country code 8. Last day of validity 1 9. Description of goods 10. CN code and textile category 11. Quantity in kilograms (net mass) or in additional units 12. Customs value in EUR, cif at Union frontier 13. Additional remarks 14. Competent authority’s endorsement Date: Place: (Signature) (Stamp) Text of image 15. ATTRIBUTIONS Indicate the quantity available in part 1 of column 17 and the quantity attributed in part 2 thereof 16. Net quantity (net mass or other unit of measure stating the unit) 19. Customs document (form and No) or extract No and date of attribution 20. Name, Member State, stamp and signature of the attributing authority 17. In figures 18. In words for the quantity attributed 1. 2. 1. 2. 1. 2. 1. 2. 1. 2. 1. 2. 1. 2. Extension pages to be attached hereto. Text of image EUROPEAN UNION SURVEILLANCE DOCUMENT 2 1. Consignee (name, full address, country, VAT No) 2. Issue No COPY FOR THE COMPETENT AUTHORITY 3. Proposed place and date of import 4. Authority responsible for issue (name, address and telephone No) 5. Declarant/representative as applicable (name and full address) 6. Country of origin Country code 7. Country of consignment Country code 8. Last day of validity 2 9. Description of goods 10. CN code and textile category 11. Quantity in kilograms (net mass) or in additional units 12. Customs value in EUR, cif at Union frontier 13. Additional remarks 14. Competent authority’s endorsement Date: Place: (Signature) (Stamp) Text of image 15. ATTRIBUTIONS Indicate the quantity available in part 1 of column 17 and the quantity attributed in part 2 thereof. 16. Net quantity (net mass or other unit of measure stating the unit) 19. Customs document (form and No) or extract No and date of attribution 20. Name, Member State, stamp and signature of the attributing authority 17. In figures 18. In words for the quantity attributed 1. 2. 1. 2. 1. 2. 1. 2. 1. 2. 1. 2. 1. 2. Extension pages to be attached hereto.