Marine Hazardous Goods Manifest Declaration
Vessel & Voyage Details
Vessel Name
Voyage No.
Port of Loading
Port of Discharge
Date
Shipper
Consignee
Dangerous Goods Information
Container/Package No.
Proper Shipping Name
Class
UN Number
Packing Group
Quantity & Unit
Additional Information
Declaration
I hereby declare that the goods described above have been packed and declared in accordance with the applicable provisions.
Name of Declarant
Signature
Date