公司名称
公司地址 公司电话
PACKING DECLARATION
Vessel Name: ……船名…………Voyage Number:…………航次………………
Consignment identifier or numerical link……箱号/封号…………
PROHIBITED PACKAGING MATERIAL STATEMENT
(Prohibited packaging material such as straw, bamboo, peat, hay, chaff, used fruit & vegetable cartons)
Have prohibited packaging materials or bamboo products been used as packaging or
Q1
dunnage in the consignment covered by this document? A1
YES
NO
√
TIMBER PACKAGING/DUNNAGE STATEMENT
(Timber packaging/dunnage includes: crates, cases, pallets, skids, and any other timber used as a shipping aid.)
Has solid timber packaging/dunnage been used in consignments covered by this document? (Solid timber does NOT include reconstituted timber, plywood or veneer) Q2a
A2a
YES
NO
√
TREATMENT CERTIFICATION (ONLY IF TIMBER/DUNNAGE IS DECLARED IN QUESTION 2) Q3
All timber packaging/dunnage used in the consignment has been (Please Indicate below) Treated and Marked in compliance with ISPM 15 Or Treated
(If Treated, a valid treatment certificate is required at time of importation) Or Not Treated
CONTAINER CLEANLINESS STATEMENT (for FCL/X consignments only - statement to be removed from document when not relevant)
The container(s) covered by this document has/have been cleaned and is/are free from material of animal and/or plant origin and soil.
Signed: ...............................手写..签名...........................
(Company Representative)
Printed name:. .. .........名字（打印）..................
Date of issue:....日/月/年......................................
(DD/MM/YYYY)