Dangerous Goods Shipping Checklist

Dangerous Goods Shipping Checklist
Complete this checklist to ensure all requirements are met before shipping dangerous goods.
Shipper's Full Name
First NameLast Name
Shipper's Company Name
Shipper's Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Consignee (Receiver) Name
First NameLast Name
Consignee's Company Name
Consignee's Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Shipment
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Description of Dangerous Goods (material name, form, etc.)
UN Number and Hazard Class
Quantity and Type of Packaging Used
Have all packages been correctly labeled and marked according to regulations?
Have all required shipping documents (e.g., Dangerous Goods Declaration, MSDS) been prepared and attached?
Emergency Contact Name and Phone Number
Additional Comments or Special Handling Instructions
Signature of Shipper/Authorized Person
Powered by Jotform SignClear
Should be Empty: