Dangerous Goods Declaration printable pdf download

DANGEROUS GOODS DECLARATION, SHIPPING NOTE

DANGEROUS GOODS NOTE

& CONTAINER/VEHICLE PACKING CERTIFICATE

Exporter

Customs reference/status

(1)

Exporter’s reference

Booking number

(2)

Forwarder’s reference

Consignee

DSHA Notification given by:

Shipper

Cargo agent

Transport operator

Shipping line

As above

(in accordance with the DSHA Regulations)

Freight forwarder

International carrier

Other UK transport details (e.g. ICD, terminal, vehicle bkg. ref., receiving dates)

For use of receiving authority only

Vessel

Port of loading

Ben My Chree

Heysham / Douglas

Port of discharge

Destination

TO THE RECEIVING AUTHORITY

Please receive for shipment the goods described below subject to your

published regulations and conditions (including those as to liability)

Douglas / Heysham

Net wt (kg)

Cube (M

)

Gross wt

of goods

(kg)

Cartridges for weapons inert projectile

Class & Division: * 1.4S

UN No: * 0012

Packing Group: * n/a

(If applicable)

NEC ________ (3)

(5)_____

(4)______ x boxes

Details of person responsible for packing / loading

Name

CONTAINER/

VEHICLE PACKING CERTIFICATE

I hereby declare that the goods

Position

described have been suitably and

securely packed/loaded in appropriate

Unit

containers / vehicles and incompatible

goods have not been packed together.

Signature *

Date*

(6)

DANGEROUS GOODS DECLARATION

Details of person responsible for packing / loading

Name

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); that the shipment is packaged in such a manner as to

Position

withstand the ordinary risks of handling and transport by sea, having

regard to the properties of the goods to be carried, and that the goods are

classified, packaged, marked and labelled in accordance with the

requirements of the Merchant Shipping (Dangerous Goods and Marine

Pollution) Regulations 1990 as currently amended. I further declare that,

Unit

if appropriate, the goods are classified, packaged & marked to comply

with the requirements of the European Agreement concerning the

International Carriage of Dangerous Goods by Road (ADR) & of Annex 1

(RID) to the Uniform Rules concerning the Contract for International

Signature

Date

Carriage of Goods by Rail (CIM) or special arrangements made between

the contracting parties to these Agreements.

(7)

Prefix and container/vehicle reg. Number

Seal number(s)

Container/vehicle size & type

Tare wt (kg) as on

Total of boxes

(9)

(8)

CSC plate

A and B

Please fill in all the * and fax back to IOMSPC Freight Office for approval 01624 645627

Dangerous Goods Declaration

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