Shippers Declaration for Dangerous Goods
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SHIPPER’S DECLARATION FOR DANGEROUS GOODS
| | |
|Shipper |Air Waybill No. ХХХ-ХХХХ ХХХХ |
| |Page Х of Х Pages |
| | |
| |Shipper’s Reference Number |
| |(optional) |
|Consignee | |
| | |
| | |
|Two completed and signed copies of this declaration must be handed to the | |
|operator. | |
| |WARNING |
|TRANSPORT DETAILS | |
|This shipment is within the |Airport of Departure: |Failure to comply in all aspects with the applicable |
|limitations prescribed for: | |Dangerous Goods Regulations may be in breach of the applicable law,|
|(Delete non-applicable) |MINSK |subject to legal penalties. |
|PASSENGER AND |CARGO AIRCRAFT | | |
|CARGO AIRCRAFT |ONLY | | |
|Airport of Destination ХХХХХХХ | |Shipment Type (Delete non-applicable) |
| | | | | |
| | |NON-RADIOACTIVE |RADIOACTIVE | |
| |
|NATURE AND QUANTITY OF DANGEROUS GOODS |
|Dangerous Goods Identification | | | |
| | | | | | | |
|UN or | |Class or |Pack-ing |Quantity and |Pack |Author-izati|
|ID No. |Proper Shipping Name |Division |Group |Type of |Inst. |on |
| | |(Subsidiary | |Packing | | |
| | |Risk) | | | | |
| | | | | | | |
|Additional Handling Information |
| |
| | |
|I hereby declare that the contents of this consignment are fully and accurately |Name/Title of Signatory |
|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 |ХХХХХХХХХ |
|to applicable international and national governmental regulations. I declare that all of|Place and Date: ХХХХХХХХ |
|the applicable air transport requirements have been met. | |
| |Signature |
| |(see warning above) |
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