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CompanyLetterhead
(MustbeissuedbythepackerorsupplierofthegoodsandMUSTincludethecompany’snameANDaddress)
PACKINGDECLARATION
VesselName:VoyageNumber:
Consignmentidentifier(s)ornumericallink(s):
(e.g.containernumber,billofladingnumberorcommercialinvoicenumber)
PROHIBITEDPACKAGINGMATERIALSTATEMENT
(Prohibitedpackagingmaterialssuchasstraw,bamboo,peat,hay,chaff,usedfruitvegetablecartons,etc)
Q1
Haveprohibitedpackagingmaterialsorbambooproductsbeenusedaspackagingordunnageintheconsignmentcoveredbythisdocument?
A1
YES
NO
TIMBERPACKAGING/DUNNAGESTATEMENT
(Timberpackaging/dunnageincludes:crates,cases,pallets,skidsandanyothertimberusedasashippingaid)
Q2
Hastimberpackaging/dunnagebeenusedinconsignmentscoveredbythisdocument?
A2
YES
NO
TREATMENTCERTIFICATION(ONLYIFTIMBER/DUNNAGEISDECLAREDINQUESTION2)
Q3
Alltimberpackaging/dunnageusedintheconsignmenthasbeen(Pleaseindicatebelow)
TreatedandMarkedincompliancewithISPM15
Or
TreatedincompliancewithDAFFTreatmentRequirements
(WithaccompanyingTreatmentCertificate)
Or
NotTreated
CONTAINERCLEANLINESSSTATEMENT(forFCL/Xconsignmentsonly–statementtoberemovedfromdocumentwhennotrelevant)
Thecontainer(s)coveredbythisdocumenthas/havebeencleanedandis/arefreefrommaterialofanimaland/orplantoriginandsoil.
Signed:PrintedName:
(Companyrepresentative)
Dateofissue:
(DD/MM/YYYY)
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