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Box 1 - Sender

Name:

Nigel

Totterdell

Company:

Building:

Street:

District:

Town/City:

Country:

Bulgaria

Postal Code

NE11 9SY

eMail:

Box 2 - Consignee

Name:

Nigel

Totterdell

Company:

Gordian Digital Trade Solutions

Building:

Street:

District:

Town/City:

Country:

Helvetica Li

Postal Code

NE11 9SY

eMail:

Box 3 - Taking Over the Goods

Contact:

Company:

Building:

Street:

District:

Date Arrival:

Time Arrival:

Time Departure:

Town/City:

Country:

Postal Code

eMail:

Box 4 - Delivery of Goods

Contact:

Company:

Building:

Street:

District:

eMail:

Town/City:

Country:

Postal Code

Opening Time:

Closing

Time:

Box 5 - Senders Instructions
Box 6 - Carrier

Name:

Nigel

Totterdell

Company:

Building:

Street:

District:

Town/City:

Country:

Helvetica Li

Postal Code

NE11 9SY

eMail:

Box 7 - Successive Carriers
Box 8 - Carrier's Reservations
             and Observations
Box 9 - Documents Handed to                           Transporter

Document Type

Reference:

Marks/No

Number

Packaging

Nature of Goods

Gross

Weight

(Kg)

Vol.

(m3)

Box 10 thru 15
Transported Goods
XYZ6579
12
Fish
20
2000
ABC3456
11
Biscuits
100
100
MNO12345
10
Soap
100
200
Box 16 - Special Agreements
Box 17 - To be Paid By
Sender
Consignee
Currency
Carriage Charges
Supplementary Charges
Customs Duties
Other Charges
Box 18 - Other useful particulars
Box 19 - Cash on Delivery
Amount:
Currency:
Box 20 - CMR Declaration
This Carriage is subject, notwithstanding any clause to the contrary, to the Convention on the Contract for the International Carriage of Goods by Road(CMR)
Box 21 - Established In
Established in:
on
Box 22 - Signature of Sender

Box 23 - Signature of Carrier

Box 24 - Goods Received

Company:

Building:

Street:

District:

Town/City:

Country:

Postal Code

Date Arrival:

Time Arrival:

Time Departure:

Box 25 - Reserved for Carrier
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