Battery Charge Declaration Form
Please complete this form to declare details of your battery shipment or transport. All information must be accurate and complete.
Full Name of Declarant
*
First Name
Last Name
Company or Organization Name (if applicable)
Contact Email
*
example@example.com
Date of Shipment/Transport
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Battery Type
*
Please Select
Lithium-ion
Lithium metal
Nickel-metal hydride (NiMH)
Nickel-cadmium (NiCd)
Lead-acid
Other
Battery Chemistry
*
Please Select
Lithium cobalt oxide (LCO)
Lithium iron phosphate (LFP)
Lithium manganese oxide (LMO)
Nickel-cadmium (NiCd)
Nickel-metal hydride (NiMH)
Lead-acid
Other
Battery Charge Level at Time of Shipment (%)
*
Number of Batteries in Shipment
*
Packaging Method
*
Original manufacturer's packaging
Non-conductive material
Individual protective packaging
Bulk packaging
Other
Mode of Transport
*
Air
Ground
Sea
Rail
Declaration Statement: I confirm that the information provided above is accurate and the batteries are packaged and shipped in accordance with applicable regulations.
*
I confirm the above statement
Submit Declaration
Should be Empty: