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Dangerous Goods Declaration

Please fill in details print out or fill in details and Submit.

1) Shipper

2) Reference number (s) e.g. bill of lading No..
customers reference No. or other
 

3) Consignee

4) Carrier

Container packing certificate/vehicle declaration

DECLARATION
It is declared that the packing of the container/vehicle has been carried out in accordance with the General introduction, IMDG Code, paragraph 12.3.7 or 17.7.7

TO BE COMPLETED FOR SHIPMENTS IN CONTAINERS OR VEHICLES

5) Name/status, company/organization of signatory

Place and date:

Signature on behalf of packer

_______________________

Vessel & voyage

6) Port of Loading

7) Additional Information

8) Port of Discharge

9) Goods delivered as:

 

Marks & numbers

Number and kind of packages

Unit Quantity**

Gross Mass (kg)**

Cubic Vol. (m3)

Type of unit:

*Proprietary/trade names alone are not sufficient. If applicable:

(1) the word 'WASTE' should precede the name;
(2) 'EMPTY UNCLEANED' or 'RESIDUE - LAST CONTAINED' should be added';
(3) 'LIMITED QUANTITY' should be added.
** When required in 9.3 of the General introduction to the IMDG Code;
*** When required

10) ADDITIONAL INFORMATION
In certain circumstances special information/certificates are required, see IMDG Code, General Introduction, paragraphs 9.7.1/9.7.2.
Any additional information should be entered in section 7 above, overieaf or attached to this form

DECLARATION
I hereby declare that the contents of this consignment are fully and accurately described above by the correct technical name (s) ( proper shipping name(s)), and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to the applicable international and national government regulations.

Yours faithfully

Signatory's Company: ____________________________________

11) Name of authorised signatory

Place and date of issue

Signature for and on behalf of shipper

Email :


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