sampleConsignor's (Shipper) CONSIGNOR'S STAMP
Agency:
Name:
Address:
Authorized by Title:_______________
AIRWAYBILL NoContact No Signature:__________________
Consignee's (Receiver) Agency, Name, and Address
Payment Receipt / Charge Code No
Contact No
Handling/Transportation Charges, Where Applicable for the Chargeable Rate (US$/Kg)
Account of:
DescriptionFROMTOUnitsTotal Volume (CuM)Total Weight (Kgs)Total Cost (US$)
SUB-TOTAL
ADD OTHER COST (As Applicable)
TOTAL CHARGES
Special Handling Instructions
We, the Consignor certify that the particulars, including the total charges (as applicable), on the face of this airwaybill are correct and that any part of the consignment does not contain any hazardous cargo or contraband and that the shipment is in proper condition for carriage, in accordance with international conventions, rules and regulations. The consignor acknowledge that THE ORGANISATION will not be held responsible for any loss or damage sustained to this cargo.
Name (in full): _______________________________ Signature: __________________________________ Date: ______________________
It is agreed that the packages/ unitized load described herein is accepted in apparent good order and condition (excepted as noted) for carriage SUBJECT TO THE TERMS AND CONDITIONS ON THE REVERSE HEREOF. All consignments may be carried by any other means unless specific contrary instructions are given herein by the consignor. The consignor also agrees that the goods stated herein may be routed via intermediate staging locations as UNHAS deems appropriate. The un-shaded areas must be completed by the Consignor. The shaded areas must be completed by UNHAS.Certification by UNHAS of Receipt of Goods
Name (in full): Location:
Date:Signature:
Certification by Consignee of Receipt of Goods
Name (in full): Location:
Date: _______________________Signature: ________________________________