Pesticide Export Transport Declaration Form
Exporter Details
Company Name
Contact Person
Address
Email
Phone
Importer Details
Company Name
Contact Person
Address
Email
Phone
Transport Details
Transport Company
Transport Mode
Road
Rail
Sea
Air
Vehicle/Container Number
Shipping Date
Port of Departure
Port of Arrival
Pesticide Details
Product Name
Active Ingredient
Quantity
Packaging Type
UN Number
Declaration
I hereby declare that the above information is true and the shipment complies with all relevant regulations.
Name
Position
Date
Signature