VGM declaration form TW SZX

Release date: 2019-05-09
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The person who fills out the forms is duly authorized by shipper. All information on this form should be true, accurate and complete abiding by IMO Guidelines. If any false statement, misinterpretation or wrong declaration showing on this form, the shipper, and it’s authorized representative shall bear the legal consequences. Please be advised without VGM, the cargo won’t be allowed by the carriers/operators to gate in the terminal or load on vessel. 
此申报单需拥有托运人完全授权才可填写. 所提供之信息需为真实正确且遵守IMO规定. 任何不实信息,或错误申报,由此产生的风险、费用、责任将一律由托运人承担。请注意, 没有提供VGM的集装箱将不予进港或装船 !
Please fill in the form in English 请用英文填写以下表格      

*  Compulsory fields 必填项

 第6项和第7项请根据实际情况在[  ]中勾选

Shipper Verified Gross Mass (VGM) Declaration Form
*Date of declaration: 申报日期
*1.Shipper (托运人):
*2. S/O or Bill of Lading Number (S/O 号或是提单号码)*3. Container Number/Seal Number (柜号/封条号)*4 Total VGM/Per container  (每柜验证总重量) *5. Unit of Measure (KG/LBS) 衡量单位 (公斤/磅)
a.


b.


c.


d.


e.


 6. [    ] Weighing method (Method 1) 衡量方法(方法1即整体称重法) 7. [    ] Weighing method (Method 2) 衡量方法(方法2即累加计算法)
本托运人声明 : 此文件资料所含载货集装箱重量信息系按照本托运人声明 : 此文件资料所含载货集装箱重量信息系按照
《1974年国际海上人命安全公约》第VI/2.4.1条所述方法获得,《1974年国际海上人命安全公约》第VI/2.4.2条所述方法获得,
称重点的衡器已取得计量技术机构颁发的计量检定证书,该方法符合主管机关制定并公布的《载货集装箱累加计算法
且获得重量的日期在证书的有效范围内。重量验证指南》的要求。


*8.Authorized Person contact details (Name/address/contact details) 授权人及其联系方式
Name:  (In Caps字母全部大写)
Address:
Phone:
9.Weighing company contact details (Name/address/contact details) 如果是由第三方度量VGM 请填写此栏
Name:  
Address:
Phone:
*请盖托运人公司的公章


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