Battery Hazardous Materials Declaration Document
1. Shipper Information
Company Name
Address
Contact Person
Phone / Email
2. Consignee Information
Company Name
Address
Contact Person
Phone / Email
3. Battery Information
Type of Battery
Manufacturer
Model/Part No.
Quantity
Weight (kg)
Packing Method
4. Regulatory Compliance
UN Number(s):
Packing Instruction:
Special Precautions/Remarks:
5. Declaration
Authorized Signature
Date
Name (Print)
Title/Position