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MULTIMODAL DANGEROUS GOODS FORM - YRC Freight

MULTIMODAL DANGEROUS GOODS FORMThis form may be used as a DANGEROUS GOODS declaration as it meets the requirements of SOLAS 74, chapter VII, regulation 54; MARPOL 79/78, Annex III,regulation Shipper/Consignor/Sender2 transport document number3 Page 1 of _____ pages4 Shipper s reference5 Freight forwarder s reference7 Carrier (to be completed by the Carrier)6 ConsigneeSHIPPER S DECLARATION I herby declare that the contents of this consignement are fully and accurately describedbelow by the Proper Shipping Name, and are classified, packaged, marked and labeled/placardedand are in all respects in proper condition for transport according to the applicable internationaland national government This shipment is within the limitations prescribed for:(Delete non-applicable)9 Additional handling informationPASSENGER ANDCARGO AIRCRAFTCARGO AIRCRAFTONLY10 Vessel/flight no. and date11 Port/place of loading12 Port/place of discharge13 Destination14 Shipping marksNumber and kind of packages; description of goodsGross mass (kg)Net mass (kg) Cube (m3)15 Container identification No.

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 54; MARPOL 79/78, Annex III, ... and are in all respects in proper condition for transport according to the applicable international and national government regulations.

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  Form, Good, Transport, Dangerous, Freight, Dangerous goods, Multimodal, Multimodal dangerous goods form, Yrc freight

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Transcription of MULTIMODAL DANGEROUS GOODS FORM - YRC Freight

1 MULTIMODAL DANGEROUS GOODS FORMThis form may be used as a DANGEROUS GOODS declaration as it meets the requirements of SOLAS 74, chapter VII, regulation 54; MARPOL 79/78, Annex III,regulation Shipper/Consignor/Sender2 transport document number3 Page 1 of _____ pages4 Shipper s reference5 Freight forwarder s reference7 Carrier (to be completed by the Carrier)6 ConsigneeSHIPPER S DECLARATION I herby declare that the contents of this consignement are fully and accurately describedbelow by the Proper Shipping Name, and are classified, packaged, marked and labeled/placardedand are in all respects in proper condition for transport according to the applicable internationaland national government This shipment is within the limitations prescribed for:(Delete non-applicable)9 Additional handling informationPASSENGER ANDCARGO AIRCRAFTCARGO AIRCRAFTONLY10 Vessel/flight no. and date11 Port/place of loading12 Port/place of discharge13 Destination14 Shipping marksNumber and kind of packages; description of goodsGross mass (kg)Net mass (kg) Cube (m3)15 Container identification No.

2 Vehicle registration Seal number(s)17 Container/vehicle & type18 Tare mass (kg)19 Total gross mass (including tare) (kg)CONTAINER / VEHICLE PACKINGCERTIFICATE I hereby declare that the GOODS described above havebeen packed/loaded into the container/vehicle identifiedabove in accordance with the applicable provisions.+MUST BE COMPLETED AND SIGNED FOR ALLCOUNTAINER/VEHICLE LOADS BY PERSONRESPONSIBLE FOR PACKING/LOADING21 RECEIVING ORGANIZATION RECEIPT Received the above number of packages/containers/trailers in apparent good order andcondition, unless stated hereon: RECEIVING ORGANIZATION REMARKS:20 Name of companyName/status of declarantPlace and dateSignature of declarantDANGEROUS GOODSYou must specify: Proper Shipping Name, hazard class, UN No., packing group, (where assigned) marine pollutant and observe the mandatory requirements under applicablenational and international government regulations. For the purposes of the IMDG Code see +For the purpose of the IMDG Code, see s nameVehicle registration and dateDRIVER S SIGNATURES ignature of declarant22 Name of company (OF SHIPPER PREPARING THIS NOTE)Name/status of declarantPlace and dateForm provided by Navigational Logistics, Inc.

3 - DANGEROUS GOODS FORM1 Shipper/Consignor/Sender2 transport document number3 Page 1 of _____ pages4 Shipper s reference5 Freight forwarder s reference14 Shipping marksNumber and kind of packages; description of goodsGross mass (kg)Net mass (kg) Cube (m3)


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