Marine Cargo Insurance Declaration Form
Name of Insured
Policy Number
Address
Contact Number
Shipment Details
Invoice Number
Date of Departure
Date of Arrival
Mode of Conveyance
Sea
Air
Land
Name of Vessel/Flight No./Vehicle No.
Port/Place of Shipment
Port/Place of Destination
Cargo Details
Description of Cargo
Quantity
Type of Packing
Sum Insured (Currency & Amount)
Rate of Premium
Remarks
Additional Remarks