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Company letterhead
                           (MUST be issued by the packer of the goods and
                        MUST include the company’s name AND physical address)
                                 FCL/X PACKING DECLARATION
Vessel name:                                        Voyage number:
Consignment identifier or numerical link:
UNACCEPTABLE PACKAGING MATERIAL STATEMENT
(Packaging material such as straw, peat, hay, chaff, used fruit & vegetable cartons are not permitted)
Q1    Have unacceptable packaging materials been used as packaging or dunnage in the
      consignments covered by this document?
A1          YES    ☐                         NO    ☐
TIMBER/BAMBOO PACKAGING/DUNNAGE STATEMENT
(Timber/bamboo packaging/dunnage includes: crates, cases, pallets, skids, and any other timber or bamboo
 used as a shipping aid)
Q2    Has timber/bamboo packaging/dunnage been used in consignments covered by this
      document?
A2          YES Timber    ☐              YES Bamboo       ☐                  NO      ☐
                                                                             (nil timber/bamboo)
TREATMENT CERTIFICATION (ONLY IF TIMBER/BAMBOO PACKAGING/DUNNAGE IS
DECLARED IN QUESTION 2)
Q3         All timber/bamboo packaging/dunnage used in the consignment has been (Please Indicate
           below)
A3         Treated and marked in compliance with ISPM 15               ☐
           (Note: ISPM 15 is only applicable to timber packaging)
           Or
           Treated in compliance with Department of Agriculture,       ☐
           Fisheries and Forestry treatment requirements
           (With accompanying treatment certificate)
           Or
           Not treated                                                 ☐
CONTAINER CLEANLINESS STATEMENT
The container(s) covered by this document has/have been cleaned and is/are free from material of animal
and/or plant origin and soil.
Signed:                                            Printed name:
            (Company Employee)                                         (Employee Name)
Date of issue:
                          (DD/MM/YYYY)
December 2024 Version