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declaration 空白表格

2012-07-25 1页 doc 32KB 31阅读

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declaration 空白表格Dangerous Goods Declaration 1. Shipper/Consignor/Sender of Record 2. Transport document number - 3. Page of pages 4. 5. Shipper’s reference Booking No. 5. Freight Forwarder's reference 6 Consignee PH 7 Carrier (to be comple...
declaration 空白表格
Dangerous Goods Declaration 1. Shipper/Consignor/Sender of Record 2. Transport document number - 3. Page of pages 4. 5. Shipper’s reference Booking No. 5. Freight Forwarder's reference 6 Consignee PH 7 Carrier (to be completed by carrier) Vessel Name and voyage 8. Emergency contact telephone (with international access code) 9. Additional handling information: 10. Place of receipt S 11. Port/place of loading 12. Port/place of discharge 13. Destination Placards/Signs: 14. Shipping marks No. and kind description of goods Gross mass (kg) of packages (PSN, Class, UN, PG) Net Explosive Qty. (class 1 only) 15. Container identification no./ vehicle registration no. T 16. Seal number(s) 17. Container/vehicle size & type 18. Tare mass (kg) 19. Total gross including tare (kg) CONTAINER/VEHICLE PACKING CERTIFICATE It is declared that the packing of the goods into the container/vehicle identified above has been carried out in accordance with the applicable provisions. MUST BE COMPLETED AND SIGNED FOR ALL CONTAINER/VEHICLE LOADS (other than tanks) BY THE PERSON RESPONSIBLE FOR PACKING/LOADING. SHIPPER’S DECLARATION 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 labeled/placarded and are in all respects in proper condition for transport according to the applicable international and national governmental regulations. MUST BE COMPLETED AND SIGNED FOR ALL DANGEROUS GOODS CONSIGNMENTS BY THE PERSON RESPONSIBLE FOR OFFERING THE DANGEROUS GOODS FOR TRANSPORT PER IMDG CODE 5.4.1.1.11. 20. Name of company packing container J. 22. Name of company of shipper Name/status of declarant Name/status of declarant Place container/vehicle packed Date packed: Place and date Signature of declarant Signature of declarant
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