No Hazardous Material Onboard Declaration

Vessel Information

Vessel Name

IMO Number

Flag

Voyage Number

Port of Loading

Port of Discharge

Consignor/Shipper Details

Company Name

Address

Contact Number

Cargo Information

Description of Cargo

I hereby declare that the cargo described above does not contain any hazardous materials as per the applicable regulations and conventions. All information provided is accurate and true to the best of my knowledge.

Name of Declarant Designation Signature

Date