Bulk Liquid Cargo Manifest Declaration Form

Vessel & Voyage Information

Vessel Name IMO Number Flag Call Sign Voyage Number Port of Loading Port of Discharge Arrival Date Departure Date

Shipper/Receiver Details

Shipper Consignee Agent

Cargo Details

Cargo Name	B/L No.	Quantity	Unit	Tank No.	Temperature	Specific Gravity	Remarks

Other Information

Remarks

Master's Name Date

Signature