Dangerous Goods Declaration Form
Shipper Information
Shipper Name
Address
Contact Number
Email
Consignee Information
Consignee Name
Address
Contact Number
Email
Shipment Details
Air Waybill / Bill of Lading No.
Date
Port of Loading
Port of Discharge
Dangerous Goods Information
Proper Shipping Name
Class/Division
UN Number
Packing Group
Quantity & Type of Packing
Additional Information
Declaration
Declaration and Signature
Place
Date
Name of Signatory