DECLARATION
ADR DANGEROUS GOODS
This document does not have to be used in case of Limited Quantities LQ (ADR 3.4) and Excepted
Quantities/EQ (ADR 3.5)
1 copy attached to the shipment, 1 copy collected in the DG Envelope dispatched to the
driver
Collo barcode number or barcode sticker
Date
Sender (or shipping label)
Numbe
r
Packagin
g Type
Receiver (or shipping label)
UN Number | Official name | Class | Class Category | Packaging
Group | [ADR]
1
2
3a
3b
4
15
1
Weight./Vo
l.
net1 (kg/L)
Weight./Vo
l.
gross
(kg/L)
For solids, liquefied gases, refrigerated liquefied gases and dissolved gases, net mass in kilograms | For objects: gross mass in kilograms |
for liquids: net capacity
in liters | For explosive substances (Class 1): net weight explosive in kilograms | for liquids and compressed gases, nominal capacity of
receptacles in liters.
 The limits of ADR 1.1.3.6 are exceeded
 Transport without exceeding the
limits of ADR 1.1.3.6:
Quanity per transport category:
Transport
Quantity
Factor
Points
XXXXXX
50
XXXXXX
Category
TNT Innight only accepts parcels
1
containing dangerous goods of
2
3
transport category 2 to 4
3
1
mentioned in the table of ADR
4
---
E5.7
chapter 1.1.3.6.3
Total
---
DECLARATION
ADR DANGEROUS GOODS
This document does not have to be used in case of Limited Quantities LQ (ADR 3.4) and Excepted
Quantities/EQ (ADR 3.5)
1 copy attached to the shipment, 1 copy collected in the DG Envelope dispatched to the
ADR statement: We hereby confirm that the packages and their contents are allowed for road
transport taking into account the provisions of the ADR and their state, nature, packaging
and
driver
labeling conform to the requirements of ADR. If multiple hazardous substances are bundled in
one package or shipment, it is hereby confirmed that the bundling is not prohibited.
E5.7
Name sender (in capitals)
Signature sender