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SHIPPER’S DECLARATION FOR DANGEROUS GOODSShipper Air Waybill No.
Page of PagesShipper’s Reference Number (optional)
Consignee
Two completed and signed copies of this Declaration
must
be handed to the operator.
WARNING
TRANSPORT DETAILS Failure to comply in all respects with the applicableDangerous Goods Regulations may be in breach ofthe applicable law , subject to legal penalties.
This shipment is within the
limitations prescribed for :
(delete non-applicable)
PASSENGE
R
AND
CARGO
AIRCRAFT
CARGO
AIRCRA
FT
ONLY
Airport of Departure
Airport of Destination :Shipment type : (delete non-applicable)
NON-
RADIOACTIVE
RADIOACTI
VE
NATURE AND QUANTITY OF DANGEROUS GOODS (see sub-Section 8.1 of IATA Dangerous Goods Regulations)
Dangerous Goods Identification
Quantity andtype of packing
Packinglnst.
Authorization
UNorIDNO.
Proper Shipping Name
Classor
DivisionSubsidiar
yRisk
Pack-ingGroup
Additional Handling Information
24-hour emergency telephone number : (including country and area code)
I hereby declare that the contents of this consignment are fully andaccurately described above by the proper shipping name , and areclassified , packaged , marked and labeled/placarded , and are in allrespects in proper condition for transport according to applicableinternational and national govermmental regulations. I declare thatall of the applicable air transport requirements have been met.
Name/Title of Signatory
Place and Date
Signature(See warning above)
TS-DG301 (JAN/2005)