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SHIPPER'S DECLARATION FOR DANGEROUS GOODS

Shipper PT. JVD Indonesia (DGEX Indonesia), Soewarna Integrated Business Park, E10, Block B, Lot 7-8,
Shipper
PT. JVD Indonesia (DGEX Indonesia), Soewarna Integrated
Business Park, E10, Block B, Lot 7-8, Soeta Int'l Airport
Tangerang 15126 Indonesia, Tel : (+6221) 5591 1067, For:
Air Waybill No.
Page
1
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PT. INDONESIA INTERNATIONAL EXPO
JL. BOULEVARD BSD BARAT KAV. OFFICE PARK NO.1
DS. SAMPORA KEC. CISAUK TANGERANG 15339, INDONESIA
Shipper's Reference Number
Draft KWE-Toyota
(optional)
Consignee
UMW TOYOTA MOTOR SDN BHD
NO.6, JALAN PJU 7/2, MUTIARA DAMANSARA, 47800
PETALING JAYA, SELANGOR
TEL : +603-7711-4154
ATTN : CHAN WEI CHUEN
Two completed and signed copies of this Declaration must
be handed to the operator.
WARNING
TRANSPORT DETAILS
Failure to
comply
in
all
respects
with
the
applicable
Dangerous
Goods
Regulations
may
be
in
breach
This shipment is within the
limitations prescribed for:
Airport of Departure:
of
the
applicable
law,
subject
to
legal
penalties.
(delete non-applicable)
PASSENGER
CARGO
Soekarno Hatta, Indonesia
AND CARGO
AIRCRAFT
AIRCRAFT
ONLY
Shipment type : (delete non-applicable)
Airport of Destination :
Kuala Lumpur, Malaysia
NON-RADIOACTIVE
RADIOACTIVE
NATURE AND QUANTITY OF DANGEROUS GOODS
Dangerous Goods Identification
UN
Class
Pack-
Or
Or Division
Quantity and
type of packing
Packing
Authorization
Inst.
Proper Shipping Name
ing
ID
(Subsidiary
Group
No.
Risk)
UN 3166
Vehicle, flammable liquid powered
9
-
1 Automobile x 2.056 Kg
950
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Additional Handling Information
24 Hour Emergency Contact Number: +62 823 7807 4550, +62 812 1047 2002, Contact Person : Arif Tawil
IATA Certificate No: 278100, SKP No: 0010669/DG.A2/DKP/XI/2016, Comp Certificate: 1168/DG-PTC/XII/16
I hereby declare that the contents of this consignment are fully and
accurately described above by the proper shipping name, and are classified,
packaged, marked and labelled/placarded, and are in all respects in proper
condition for transport according to applicable International and national
governmental regulations. I declare that all of the applicable air transport
requirements have been met.
Name/Title of Signatory
Arif Tawil / Operation Specialist
Place and Date
Jakarta, August 23, 2018
Signature
(see warning above)

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