Dangerous Goods Declaration for Crew Members

Airline Name

Flight Number

Date

Crew Member Information

Full Name

Crew ID / Employee No.

Position

Dangerous Goods Information

Description of Item(s)

Quantity

UN Number

Class/Division

Packing Group

Purpose/Use on Board

Declaration

I hereby declare that the above information is true and correct to the best of my knowledge and that I am carrying these item(s) in accordance with airline policies and international regulations.

Signature

Date