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~fA Documentation

FIGURE 8.1.8
Shipper's Declaration Specimen Designed for Manual Completion
"'l1lI SHIPPER'S DECLARATION FOR DANGEROUS GOODS ""II1II

~ Ipper
Air Waybill No. Enter
~

~ Enter ~
Page 1 of 1 Pages
Shipper's Reference Number
~ (optional) ~
Consignee
~ For optional use ~
Enter for
~ Company logo ~
name and address
~ ~
Two completed and signed copies of this Declaration must WARNING
~ 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 Shipment type: (delete non-appficable)
I NON-RADIOACTIVE I RADIOACTIVE I ~
~ NATURE AND QUANTITY OF DANGEROUS GOODS
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -:- - - - - - - - - - - - - - - - - - - - - - - - -,- - - - - - -,- - - - - - - - - - - - - --
~
Dangerous Goods Identification , ' ,
~ - -UN
- - - -:-- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -, - - - - - - - - - -,-- - - - - -: : : ~
or :
' "
: Class: P!lck-:
,
Quantityand :,' Packing: ,
Authorization
~ No :
ID' Proper Shipping Name : or DIVIsion'
' (Subsidiary: Group:
mg' type of packing
:
Ins!. :
'
~
. : : Risk): : ' :
~ Enter Enter i"Enter Ente , Enter ~
- - - - - -r - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
, - - - - - - - - - -~
' Ent Enter
- - - - - -~ - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - -j- - - - - - - - - - - - - - -

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~ -------------------------------------------
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~ 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 ~
accurately described above by the proper shipping name, and are Enter
~ classified, packaged, marked and labelled/placarded,
respects in proper condition for transport according
and are in all
to applicable
Place and Date ~
Enter
~ international and national governmental
of the applicable air transport requirements
regulations. I declare that
have been met.
all
Signature
(see warning above)
~
~ ~
t. t.

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