Marine Cargo Insurance Declaration Form
Insured Name
Contact Number
Address
Policy Number
Date of Declaration
From (Port of Loading)
To (Port of Discharge)
Mode of Conveyance
Sea
Air
Land
Multimodal
Vessel/Flight/Vehicle Name
B/L or AWB Number
B/L or AWB Date
Description of Goods
Number of Packages
Total Weight (kg)
Type of Packing
Sum Insured (Currency & Amount)
Remarks