| Sender Name:_________________________________________________ |
| Address:____________________________________________________________ |
| ___________________________________________________________________ |
| Date of Arrival at Destination:________ / ________ / ________________________ |
| Telephone: (B.H) _______________________ (A. H) ________________________ |
| |
 |
| |
| Important: Please read carefully |
* Delete where appropriate |
|
| a) |
All Goods were personally packed by me and have been in mu constant possession since packing. |
| b) |
I have declared all ELECTRICAL ITEMS on the packing list. |
| c) |
My consignment contains personal effects only and NO goods of a hazzardous nature, nor any explosive, corrosive, or firearms of any description. |
| d) |
I hereby declare that the above information is true and correct. |
| |
|
Passport No.: |
_______________________ |
Today's Date: |
________ / ________ / ________ |
Place of Issue: |
_______________________ |
Date of Issue: |
________ / ________ / ________ |
Nationality: |
_______________________ |
Signature: |
_____________________________ |
|
