SHIPPER'S DECLARATION FOR DANGEROUS GOODS
Air Waybill No.
Page ___ of ___ Pages
Shipper's Reference No.
Two completed and signed copies of the Declaration must be handed
to the operator.
This shipment is within the limitations
Airport of Departure:
Failure to comply with the applicable Dangerous Goods
Regulations may be in breach of the applicable law,
subject to legal penalties.
Shipment type: (delete non-applicable)
Airport of Destination:
NATURE AND QUANTITY OF DANGEROUS GOODS
Dangerous Goods Identification
UN or ID
No. Proper Shipping Name
Quantity and Type of Packing
Additional Handling Information:
24 HR Emergency Contact Telephone:
Name/Title of Signatory
Place and Date
(See warning above)
ShipMate, Inc., 1-310-370-3600, www.shipmate.com
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