IMO DANGEROUS GOODS DECLARATION
This form meets the requirements of SOLAS 74 chapter VII, regulation 5; MARPOL 73/78 Annex III, regulation 4 and the
IMDG Code, chapter 5.4.
Consignor (name, address):Avon Products , inc.
> 6219 Wooster Pike
> Cincinnati, OH 45227
431 Battlefield Memorial Highway
Building 211
Richmond KY 40475 / Shippers Reference Nbrs:
1251 Avenue of the Americas / Carrier:
New York, New York 10020, USA / Freight Forwarder Reference
Consignee (name, address):
Avon Korea
11F1 SHIN-IL BLDG #143-39
SAMSUNG-DONG, KANGAM-GU
Seoul, Korea / Container/ Vehicle Packing Certificate
I hereby declare that the goods described below have been packed /
Loaded into the container / vehicle identified above in accordance
With the applicable provisions
TO BE COMPLETED AND SIGNED FOR ALL CONTAINER /
VEHICLE LOADS BY PERSONS RESPNSIBLE FOR PACKING/ LOADING
Additional Handling Information
Emergency Contact Number: 24 hour ER telephone# 001-813-248-0585 / Chemtel Avon Products / Name of Company / Name / Status
Place and Date:
Ship's Name and Voy. #:
/ Port of Loading:
/ Signature of Declarant :
Port of Discharge / Destination / Goods Delivered As: / Type of Unit & Unit Nbr.:
No Qty., Type & Kind of Dangerous goods description*
Pkgs. Size / Gross Mass (kg) Net Mass (kg)
60 Fiberboard boxes UN 1266 Perfumery Products with flammable liquid
Containing (3182) Class 3, PGIII, (38’C c.c.) EMS: F-E, S-D
50 ml glass bottles
Limited Quantity
/ 1423 Kg 897 Kg
Additional Information:
SHIPPERS DECLARATION
It is hereby declared that the contents of this consignment
are fully and accurately described above by the proper
shipping name(s) and are classified, packaged, marked / Name of Company / Name / Status of declarant
Chad Martin / DG Coordinator / MMTPS
and labeled/placarded, and are in all respects in proper
condition for transport according to applicable
international and governmental regulations. / Place & Date: Cincinnati, OH / 07-Oct-2010
Signature of Declarant
* The following shall be specified: UN No., Proper Shipping Name, hazard class, packing group (where assigned) and marine pollutant; additional information when appropriate shall be placed after the dangerous goods description. For the purposes of the IMDG Code see 5.4.1.4