AMSA250 Multimodal Dangerous Goods Form(AMSA250 Multimodal危险货物的形式).pdfVIP

AMSA250 Multimodal Dangerous Goods Form(AMSA250 Multimodal危险货物的形式).pdf

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AMSA250 Multimodal Dangerous Goods Form(AMSA250 Multimodal危险货物的形式)

MULTIMODAL DANGEROUS GOODS FORM This form meets the requirements of SOLAS 74 Chapter VII regulation 4 and MARPOL 73/78 Annex III regulation 4. Note: When this form is used as a container/vehicle packing certificate only, not a combined document, a dangerous goods declaration signed by the shipper or supplier must have been issued/received to cover each dangerous goods consignment packed in the container. The container/vehicle packing certificate is not required for tanks. Page 1 of 2 1. Shipper/Consignor/Sender 2. Transport document number 3. Page of pages 4. Shipper’s reference (page auto-numbers top right) 24 hour contact number: 5. Freight forwarder’s reference 6. Consignee 7. Carrier (to be completed by the carrier) SHIPPERS DECLARATION (refer to box 22 below) I hereby declare that the contents of this consignment are fully and accurately described below by the proper shipping name(s), and are classified, packaged, marked and labelled/placarded, and are

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