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Shipper Consignee WARNING Failure to comply in all respects with the applicable Dangerous Goods Regulations may be in breach of the applicable law, subject to legal penalties. Two completed and signed copies of this Declaration must be handed to the operator. TRANSPORT DETAILS This shipment is within the limitations prescribed for: (delete non-applicable ) Airport of Departure (optional): PASSENGER AND CARGO AIRCRAFT CARGO AIRCRAFT ONLY Shipment type: (delete non-applicable) NON-RADIOACTIVE RADIOACTIVE Airport of Destination (optional): NATURE AND QUANTITY OF DANGEROUS GOODS Dangerous Goods Identification UN or ID No. Proper Shipping Name Class or Division (subsidiary hazard) Packing Group Quantity and Type of Packing Packing Inst. Authorization Additional Handling Information I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged marked and labelled/placarded, and are in all respects in proper condition for transport according to applicable international and national governmental regulations. I declare that all of the applicable air transport requirements have been met. Name of Signatory Date Signature (See warning above) Air Waybill No. Page of Pages Shipper’s Reference No. (optional) SHIPPER’S DECLARATION FOR DANGEROUS GOODS

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Page 1: SHIPPER’S DECLARATION FOR DANGEROUS GOODS Shipper …...Shipper Consignee WARNING Failure to comply in all respects with the applicable Dangerous Goods Regulations may be in breach

Shipper

Consignee

WARNING

Failure to comply in all respects with the applicable Dangerous Goods Regulations may be in breach of the applicable law, subject to legal penalties.

Two completed and signed copies of this Declaration must be handed to the operator.

TRANSPORT DETAILSThis shipment is within the limitationsprescribed for:

(delete non-applicable )

Airport of Departure (optional):

PASSENGER ANDCARGO AIRCRAFT

CARGOAIRCRAFT ONLY

Shipment type: (delete non-applicable)

NON-RADIOACTIVE RADIOACTIVEAirport of Destination (optional):

NATURE AND QUANTITY OF DANGEROUS GOODS

Dangerous Goods Identification

UN orID No.

Proper Shipping Name Class or Division(subsidiary hazard)

PackingGroup

Quantity and Type of Packing PackingInst.

Authorization

Additional Handling Information

I hereby declare that the contents of this consignment are fully and accuratelydescribed above by the proper shipping name, and are classified, packagedmarked and labelled/placarded, and are in all respects in proper condition fortransport according to applicable international and national governmentalregulations. I declare that all of the applicable air transport requirements havebeen met.

Name of Signatory

Date

Signature (See warning above)

Air Waybill No.

Page of Pages

Shipper’s Reference No.(optional)

SHIPPER’S DECLARATION FOR DANGEROUS GOODS

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