Hazardous Materials (HAZMAT) Cargo Manifest
Shipper Information
Company Name:
Contact Name:
Phone:
Email:
Address:
Consignee Information
Company Name:
Contact Name:
Phone:
Email:
Address:
Shipment Details
Manifest Number:
Date:
Origin:
Destination:
Carrier/Transporter:
Driver Name:
HAZMAT Cargo Details
Item No.
Shipping Name / Description
UN/NA Number
Hazard Class/Division
Packing Group
Quantity & Unit
Pkg Type
Emergency Contact
Special Handling
Additional Notes