Dangerous Good Declaration Form
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2Dangerous Good Declaration Form
DANGEROUS GOODS DECLARATION & PACKING DECLARATION
NATURE AND QUANTITY OF DANGEROUS GOODS
Con Note Ref:
Delivery Number:
Dangerous Goods Identification
Order Ref:
Item 1
Item 2
Item 3
Item 4
Item 5
UN Number
Proper Shipping Name
Common Name
Class
Packing Group
Quantity and Packing
Type
Packing Instructions
Authorisation
Marine Pollutant (Y/N)
Haz-Chem Code
Volume (m3)
Weight (kg)
Additional Handling Information
SHIPPER/
Phone:
RECEIVER/
CARRIER:
CONSIGNOR:
CONSIGNEE:
Fax:
SHIPPING UNITS:
Dangerous Goods Declaration
Name:
I Hereby declare that the contents of this consignment are
Title:
Signature:
fully and accurately described above by the proper shipping
Company/Location:
name and are classified, packaged, marked & labelled, and
are in all respects in proper condition FOR transport
Date:
according to the applicable international and national rules,
regulations and Legislation.
Packing Declaration
Name:
Signature:
Consignor: This is to certify that the above named
Title:
Dangerous Goods are properly classified. Described,
Company/Location:
Date:
packaged, marked and labelled and are in proper condition
or transport according to the provisions of the Australian
Dangerous Goods Code Version Seven.
SAFTEY INFORMATION
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Parent category: Financial