"Annual Packing Declaration Form"

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______________________________ ______________________________
Company Letterhead
(MUST be issued by the packer or supplier of the goods, and MUST include the company’s name
AND address)
ANNUAL PACKING DECLARATION
Exporter’s Name: (This information combined with the importer’s name may be used as consignment
link)
Importer’s Name:
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
Q1
or 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
Q2a
document?
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 in compliance with DAFF Treatment
Requirements
(With accompanying Treatment Certificate)
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 will be/is cleaned and will be/ is free from material of animal
and/or plant origin and soil
Signed: ............................................................
Printed name:..............................................
(Company Representative)
Date of Issue:…………………………….
(DD/MM/YYYY)
______________________________ ______________________________
Company Letterhead
(MUST be issued by the packer or supplier of the goods, and MUST include the company’s name
AND address)
ANNUAL PACKING DECLARATION
Exporter’s Name: (This information combined with the importer’s name may be used as consignment
link)
Importer’s Name:
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
Q1
or 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
Q2a
document?
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 in compliance with DAFF Treatment
Requirements
(With accompanying Treatment Certificate)
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 will be/is cleaned and will be/ is free from material of animal
and/or plant origin and soil
Signed: ............................................................
Printed name:..............................................
(Company Representative)
Date of Issue:…………………………….
(DD/MM/YYYY)