CONSIGNMENT NOTE
NOT NEGOTIABLE
DELIVER GOODS FOR EXPORT TO:
Channel Island Lines
Berth 45, Central Road, Eastern Docks, Gate 4, SOUTHAMPTON, SO14 3AH
Tel: 01534 825691.Fax:02380 633537. Email:
Consignor (Sender) / Consignee (Receiver)
Address: / Address:
Tel: / Contact Name: / Tel: / Contact Name:
QTY / TYPE OF PACKAGE / CONSIGNMENT DETAILS / VALUE £ / C of O / WEIGHT / MEASUREMENT M3
UNIT NUMBER(S) / SEAL NUMBER(S)
Are the goods Hazardous? YES / NO / If yes, please attach the required documentation for the transportation of the goods. A surcharge will be applied for the processing of Dangerous Goods Cargo. Hazardous class 1 requires 24 hours notice prior to arrival.
BILLING INSTRUCTIONS (To be completed by exporter)
Who will pay CHARGES? Please tick box below / Do you require MARINE INSURANCE? YES / NO
Consignor / Consignee / Other / Value for insurance: £
All marine insurancecover will be restricted within the terms provided by an independent marine underwriter, copies available on request.
UK Road Haulage / [ ] / [ ] / [ ]
Shipping / Delivery / [ ] / [ ] / [ ]
Insurance / [ ] / [ ] / [ ] / Any other instructions
Invoice Address if NOT Consignor / Consignee
Reference Numbers
CUSTOMS AND EXCISE DECLARATION (To be completed by exporter)
Failure to supply supporting invoices in triplicate along with the correct completion of this consignment note with insertions where necessary together with any appropriate Community Transport document may result in delivery of goods being stopped by the Customs Authorities. Community and Non-Community goods must not be declared on the same consignment note.
CUSTOMS DECLARATION / 1.I / We declare that the information entered in this Consignment Note and Customs Declaration is complete and correct in respect of all the goods in which this Declaration relates, and
2.I / We instruct Channel Island Lines or its Agents to act on my / our behalf in connection with the presentation for authentication of any appropriate Community Transit document or document in lieu in accordance with the information furnished in this declaration.
3.*I / We declare that the goods described above are Community goods.
*If they are Non-Community goods paragraph 3 must be deleted.
Each question to be answered ‘YES or NO’ by CONSIGNOR
1.Are the goods Community goods, that is, originating in or in Free circulation in the EC?
2.Are the goods in transit or transhipment through the United Kingdom?
3.Are the goods ex United Kingdom bond? / Signature of Authorised Representative / Date
*If the answer to question 1 is NO Para. 3 of the declaration on the right must be deleted.
No claim in respect of this consignment will be recognised unless notified Channel Island Lines within 24 hours of receipt of goods. In the absence of any such claim it will be assumed that the consignment is correct in all aspects.