APPENDIX NO.1

DECLARATION

VESSELS CARRYING DANGEROUS CARGOES

( Packaged / Bulk dangerous Cargoes )

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I, the undersigned, ...................................................................... Master of M/V ..................................……….............................., owned by ............................................................, carrying dangerous cargoes ................................................................., as shown on list herewith, enclosed and established according to Suez Canal Rules of Navigation for vessels carrying dangerous cargo , do hereby declare and certify , on behalf of the owners, as follows :

(1)The vessel is specially classed for the carriage of.................... in Class....................................................

(2)The vessel's safety equipment and radio telegraphy were inspected under the Authority of........................, and are in good working conditions.

(3)The cargo has been packed , stowed and segregated in accordance with IMDG code, and has not been disturbed.

(4)The vessel ( has been/has not been ) rendered gas free or free from explosive gases.

Place and Date : ..........................

Master's Signature :

Related Declarations

Declaration “A”

Declaration “B”

Declaration “C”