Hazardous Materials Bill of Lading
Shipper Name
Address
Contact Number
Consignee Name
Address
Contact Number
Date
Bill of Lading Number
Carrier Name
Vehicle Number
Hazardous Materials Details
HM
Proper Shipping Name
Hazard Class/Division
UN/NA Number
Packing Group
Quantity
Type of Packaging
Emergency Contact
Special Instructions / Additional Information
Shipper's Signature
Date
Carrier's Signature
Date
Consignee's Signature
Date