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Fillable Printable Shipper's Application for Dangerous Goods

Fillable Printable Shipper's Application for Dangerous Goods

Shipper's Application for Dangerous Goods

Shipper's Application for Dangerous Goods

SHIPPER'S DECLARATION FOR DANGEROUS GOODS
Shipper
Air Waybill No.
Page of Pages
Shipper's Reference Number
(optional):
Consignee
Two completed and signed copies of this Declaration must
be handed to the operator.
TRANSPORT DETAILS
This shipment is within the
limitations prescribed for:
(delete non-applicable)
Airport of Departure
Airport of Destination:
WARNING
Failure to comply in all respects with the applicable
Dangerous Goods Regulations may be in breach of the
applicable law, subject to legal penalties. This Declaration
must not, in any circumstances, be completed and/or
signed by a consolidator, a forwarder or an IATA cargo
agent.
Shipment type:(delete non-applicable)
NATURE AND QUANTITY OF DANGEROUS GOODS
Dangerous Goods Identification
Proper Shipping Name
Class
or
Divi-
sion
UN
or
ID
No.
Pack-
ing
group
Subsi-
diary
Risk
Quantity and
type of packing
Packing
Inst.
Authorization
Additional Handling Information
24 hr. Emergency Contact Tel. No.: shipment is made under the provisions of ICAO
I hereby declare that the contents of this consignment are fully and
accurately described above by the proper shipping name, and are
classified, packaged, marked and labelled/placarded, and are in all
respects in proper condition for transport according to applicable
international and national governmental regulations.
Name/Title of Signatory
Place and Date
Signature
(see warning above)
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