IMO DANGEROUS GOODS DECLARATION



IMO DANGEROUS GOODS DECLARATION

This form meets the requirements of SOLAS 74 chapter VII, regulation 5; MARPOL 73/78 Annex III, regulation 4 and the

IMDG Code, chapter 5.4.

|Consignor (name, address): |Shippers Reference Nbrs: |

|Avon Products , inc. | |

|> | |

|> 6219 Wooster Pike | |

|> | |

|> Cincinnati, OH 45227 | |

|431 Battlefield Memorial Highway | |

| | |

|Building 211 | |

| | |

|Richmond KY 40475 | |

|1251 Avenue of the Americas |Carrier: |

|New York, New York 10020, USA |Freight Forwarder Reference |

|Consignee (name, address): |Container/ Vehicle Packing Certificate |

|Avon Korea |I hereby declare that the goods described below have |

|11F1 SHIN-IL BLDG #143-39 |been packed / |

|SAMSUNG-DONG, KANGAM-GU |Loaded into the container / vehicle identified above in |

|Seoul, Korea |accordance |

| |With the applicable provisions |

| | |

| |TO BE COMPLETED AND SIGNED FOR ALL CONTAINER / |

| |VEHICLE LOADS BY PERSONS RESPNSIBLE FOR PACKING/ LOADING|

|Additional Handling Information |Name of Company / Name / Status |

|Emergency Contact Number: 24 hour ER telephone# 001-813-248-0585 / Chemtel Avon Products | |

| |Place and Date: |

|Ship's Name and Voy. #: |Port of Loading: |Signature of Declarant : |

|Port of Discharge / Destination |Goods Delivered As: |Type of Unit & Unit Nbr.: |

| No Qty., Type & Kind of Dangerous goods description* | Gross Mass (kg) Net Mass (kg) |

|Pkgs. Size | |

|60 Fiberboard boxes UN 1266 Perfumery Products with flammable liquid |1423 Kg 897 Kg |

|Containing (3182) Class 3, PGIII, (38’C c.c.) EMS: F-E, S-D | |

|50 ml glass bottles | |

|Limited Quantity | |

|Additional Information: | |

|SHIPPERS DECLARATION |Name of Company / Name / Status of declarant |

|It is hereby declared that the contents of this consignment |Chad Martin / DG Coordinator / MMTPS |

|are fully and accurately described above by the proper | |

|shipping name(s) and are classified, packaged, marked | |

|and labeled/placarded, and are in all respects in proper |Place & Date: Cincinnati, OH / 07-Oct-2010 |

|condition for transport according to applicable | |

|international and governmental regulations. | |

| |Signature of Declarant |

* The following shall be specified: UN No., Proper Shipping Name, hazard class, packing group (where assigned) and marine pollutant; additional information when appropriate shall be placed after the dangerous goods description. For the purposes of the IMDG Code see 5.4.1.4

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download