1、 MULTIMODAL DANGEROUS GOODS FORM This form may be used as a dangerous goods declaration as it meets the requirements of SOLAS 74, chapter VII, regulation 4; MARPOL 73/78, Annex III, regulation 4 2 Transport document number 3 Page 1 of pages 4 Shippers reference 1 Shipper/Consignor/Sender 5 Freight F
2、orwarders reference 6 Consignee 7 Carrier (to be completed by the carrier) SHIPPERS DECLARATION I hereby declare that the contents of this consignment are fully and accurately described below by the Proper Shipping Name, and are classified, packaged, marked and labelled/placarded and are in all resp
3、ects in proper condition for transport according to the applicable international and national governmental regulations. 8 This shipment is within the limitations prescribed for:(Delete non-applicable) PASSENGER AND CARGOAIRCRAFT CARGO AIRCRAFTONLY 10 Vessel/flight no. and date 11 Port/place of loadi
4、ng 12 Port/place of discharge 13 Destination 9 Additional handling information 14 Shipping marks *Number and kind of packages; description of goods Gross mass (kg) Net mass (kg) Cube (m3) 15 Container identification No./ vehicle registration No. 16 Seal number(s) 17 Container/vehicle size description of goods Gross mass (kg) Net mass (kg) Cube (m3)
