Header of the authorityHealth Certificate for the importation into the European Union ofConsignment Code: …Certificate Number: …According to the provisions of Commission Implementing Decision 2011/XXXX/EU on emergency measures regarding unauthorised genetically modified rice in rice products originating from China and repealing Decision 2008/289/EC(competent authority referred to in Article 4(1) of Implementing Decision 2011/XXXX/EU)CERTIFIES that the …(insert foodstuffs/feed referred to in Article 1 of Implementing Decision 2011/XXXX/EU)of this consignment composed of: …(description of consignment, product, number and type of packages, gross or net weight)embarked at …(embarkation place)by …(identification of transporter)going to …(place and country of destination)which comes from the establishment …(name and address of establishment)have been produced, sorted, handled, processed, packaged and transported in line with good hygiene practices.From this consignment, samples were taken in accordance with Annex II of Implementing Decision 2011/XXXX/EU on … (date), subjected to laboratory analysis on … (date) in the … (name of laboratory), to determine the absence of any unauthorised GM Rice.The details of sampling, methods of analysis used and all results are attached.This certificate is valid until …Done at: … on …Stamp and signature of authorised representative of competent authority referred to in Article 4(1) of Implementing Decision 2011/XXXX/EU