Dangerous Goods Declaration Form

This form serves to declare that the contents of a shipment have been classified, packed, marked, and labeled in accordance with applicable international and national regulations concerning the transport of dangerous goods.

Shipper Information

• Name: {shipperName}
• Company: {shipperCompany}
• Address: {shipperAddress}
• Phone: {shipperPhone}

Consignee Information

• Name: {consigneeName}
• Company: {consigneeCompany}
• Address: {consigneeAddress}
• Phone: {consigneePhone}

Transport Details

• Carrier: {carrierName}
• Flight/Ship Number: {transportNumber}
• Date of Transport: {transportDate}
• Port/Airport of Departure: {departureLocation}
• Port/Airport of Arrival: {arrivalLocation}

Dangerous Goods Description

Emergency Contact

• Contact Name: {emergencyName}
• Phone Number: {emergencyPhone}
• Organization: {emergencyOrganization}

Declarations

• 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 labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national governmental regulations.
• Declared By: {declarantName}
• Position: {declarantPosition}
• Date: {declarationDate}

Special Handling Information

{#hasSpecialHandling}

• {specialHandlingInstructions}

{/hasSpecialHandling}

{^hasSpecialHandling}

No special handling instructions provided.

{/hasSpecialHandling}