Fax: 01856 851795 freight@northlinkferries.co

1 NorthLink Ferries Stromness Ferry Terminal Ferry Road Stromness, Orkney KW16 3BH T +44 (0)845 6000 449 E Registered Office: Serco Limited 16 Bartley W ay Bartley W ood Business Park Hook, Hampshire, RG27 9UY Company Registration No. 242246 Operated by COMPLETING THIS DOCUMENT FOR DIVERS 1. Booking Reference 2. Company/Person s Name, Home Address and Contact Number 3. Company/Person s Name, Away Address and Contact Number 4. Vessel s Name (Found on Booking Confirmation) 5. Port of Loading 6. Port of Discharge (Destination) 7. Enter Proper Shipping Name, Class and Division, UN Number and quantity of items 8. Gross Weight of Product 9. Total Weight of all Products 10. Name, Signature and Date where possible vehicle make/model and registration 11. Name, Signature and Date Please also try to include departure/arrival dates and times. VEHICLE PACKING CERTIFICATE (Box 10) It is certified that: 1. The vehicle was clean, dry and apparently fit to receive/carry goods 2.

2 No incompatible goods have been packed into the vehicle unless specially authorised by the Competent Authority 3. All cylinders have been externally inspected for damage and only sound packages packed; 4. All cylinders have been properly packed and secured in the vehicle; 5. All full cylinders must have an in-date test certificate THE SHIPPER S DECLARATION (Box 11) covers the following regulations The International Maritime Dangerous Goods Code (IMDG Code), as revised or re-issued from time to time by the International Maritime Organisation (IMO) If signing the document, the shipper is confirming that in accordance with the applicable Regulations; i) The dangerous goods as presented may be carried; ii) The dangerous goods and any packaging, intermediate bulk container or tank in which they are contained are in a fit condition for carriage and are properly labelled; and iii) Where several packaged are packed together in an overpack or in a single container, that this mixed packaging is not prohibited.

3 If you require assistance in completing this document, please contact our Customer Service Department by calling 0845 6060 449 For more information visit This document must be forwarded to NorthLink Ferries a minimum of 24 hours prior to departure, and must also be handed in at our check-in office upon arrival F a x : 0 1 8 5 6 8 5 1 7 9 5 f r e i g h t@n o r t h l i n k f e r r i e s . c o . u k Exporter (Name and Address) Jamejnd Booking Reference Consignee (Name and Address) Freight Forwarder (if applicable) Date/Time of Departure Date/Time of Arrival The below is a declaration which states 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 proper condition for transport according to the applicable national and international regulations, and as per any additional condition(s) applied by NorthLink Ferries.

4 The shipper must complete and sign the shipper declaration at the bottom of this page. Port of Loading Port of Discharge Vessel Name Proper Shipping Name: IMO Hazard Class: UN Number: Packing Group (If Applicable): EmS: Proper Shipping Name: IMO Hazard Class: UN Number: Packing Group (If Applicable): EmS: Shipping Marks/ Number and kind of packages; description of goods SPECIFY; Proper Shipping Name*, IMO Hazard Class, UN , Additional Information (see reverse) SPECIFY Net weight (kg) of goods Gross weight (kg) of goods Cube (m3) of goods SPECIFY Total gross weight of goods Total cube of goods Vehicle Registration Number Tare (kg) Gross weight incl. Tare Vehicle Size/Type Seal Number Freight Forwarder NorthLink Ferries For Divers Only Dangerous Goods Declaration and Packing Certificate VEHICLE PACKING CERTIFICATE THIS DECLARATION MUST BE COMPLETED AND SIGNED FOR ALL THE VEHICLE LOADS BY THE PERSON RESPONSIBLE FOR PACKING/LOADING. Company Name Name of Declarant Place and Date Signature of Declarant Name and telephone number of shipper preparing this document Name/status of declarant Place and date Signature of declarant Haulier s Name Vehicle Registration Number Driver s Signature S h i p per D e c l a r a t i on *Proper Shipping Name Trade names alone are not acceptable Please refer to the latest editions of the IMDG NorthLink Ferries F o r m o r e i n f o r m a t i o n c a l l ou r C u s t o m e r S e r v i c e D e p a r t m e n t o n 0 8 4 5 6 0 6 0 4 4 9 !

5 Please read terms overleaf before submitting this document. DAN G E R O U S G O O D S N O T E - D I V I N G C Y L I N D E R S O N L Y 1 2 3 4 5 6 7 8 11 10 9