Dangerous Goods Declaration Form
Shipper Details
Name
Address
Contact Number
Consignee Details
Name
Address
Contact Number
Transport Details
Flight/Vessel No.
Date of Departure
Port of Loading
Port of Discharge
Dangerous Goods Information
Proper Shipping Name
Class/Division
UN Number
Packing Group
Quantity & Type of Packing
Additional Information
Certification
Name of Signatory
Title
Date
Signature