Dangerous Goods Regulations may be in breach of the applicable law, subject to
legal penalties. Airport of Departure: Shipment type: (delete non-appficable).
~fA
Documentation FIGURE 8.1.8 Shipper's "'l1lI
SHIPPER'S
Declaration DECLARATION
Specimen
FOR DANGEROUS
Designed
for Manual Completion
GOODS
""II1II
Ipper ~ Air Waybill No. Enter Enter ~ Page 1 of 1 Pages Shipper's Reference Number ~ (optional) Consignee ~ For optional use for Enter ~ Company logo name and address ~ WARNING Two completed and signed copies of this Declaration must ~ be handed to the operator. TRANSPORT DETAILS Failure to comply in all respects with the applicable ~ Dangerous Goods Regulations may be in breach of Airport of Departure: the applicable law, subject to legal penalties. ~ Enter ~ ~ Airport of Destination: Enter ~ NATURE AND QUANTITY OF DANGEROUS GOODS Dangerous Goods Identification , ' , - - - -:-- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -, - - - - - - - - - -,-- - - - - -: : : ~ - -UN ' " , , or : : Class: P!lck-: Quantity and :,' Packing: Authorization : or DIVIsion' mg' type of packing Ins!. : ID' Proper Shipping Name ~ No : ' (Subsidiary: Group: : ' . : : Risk): : ' : ~ Enter Enter i"Enter Ente , Enter , ' Ent Enter ,, "" ,, '' er r , " , ' ~ '' ,,, """ '' ,, "" '' ~ ,, "" '' ,, "" '' ,, "" '' ~ ,, "" '' ,, "" '' , " ~ ,, "" '' ,, " ' ,. ,, "" ~ ,, "" ,, ,. " ,, "" ~ ,, "" ,, "" , "" ~ ------------------------------------------, , , ~ Additional Handling Information ~ 24 Hour Emergency Contact Telephone Number: Enter ~ I hereby declare that the contents of this consignment are fully and Namemtle of Signatory Enter accurately described above by the proper shipping name, and are packaged, marked and labelled/placarded, and are in all Place and Date ~ classified, respects in proper condition for transport according to applicable Enter and national governmental regulations. I declare that Signature ~ international of the applicable air transport requirements have been met. ~ t. Shipment type: (delete non-appficable) I NON-RADIOACTIVE I RADIOACTIVE
I
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -:- - - - - - - - - - - - - - - - - - - - - - - - -,- - - - - - -,- - - - - - - - - - - - - --
- - - - - -r - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - -~
- - - - - -~ - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - -j- - - - - - - - - - - - - - -
all
(see warning
~
~ ~
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
-8.1
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
above)
~ t.
593
