I just got out our "Adoption Guide Book" from our agency to answer your questions. It has samples of all the forms. We did this with both of our adoptions so I'm assuming it's correct.
For #13 (date of departure)- we were told to put "
unknown" for a., b., and for c. city = "write country only".
Also for #14, "Will the child come to the US for adoption after compliance with preadoption....." we were told to check "
NO".
Hope this helps.

__________________
www.babyhomepages.net/kristykeith/index.php
DD- GUA bday 12/13/04
Referral - 4/05/05
In PGN - 7/06/05
OUT of PGN - 7/18/05 (Amazingly only 2 weeks! God is good!!!)
Home Forever - 8/05/05
DD's- GUA Twins (bday 3/15/06, referral)
In PGN- 6/27/06
Visited girls - 7/12- 7/16/06
OUT of PGN- 8/17/06
Rec'd BC- 8/24/06
Rec'd
PINK!! - 8/30/06
Embassy Appointment - 9/11/06
Home Forever- 9/13/06