Maritime Hazardous Cargo Declaration
1. Shipper Details
Name/Company:
Address:
Contact Number:
Email:
2. Consignee Details
Name/Company:
Address:
Contact Number:
Email:
3. Vessel & Voyage Particulars
Vessel Name:
Voyage Number:
Port of Loading:
Port of Discharge:
4. Cargo Details
Proper Shipping Name
UN Number
IMDG Class
Packing Group
Quantity & Unit
Type of Packaging
5. Additional Information
Emergency Contact:
Remarks:
6. Declaration
Name / Signature:
Date: