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Section+II+Li Battery+Declaration+Form+2015+(instruction) .pdf


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Shipper’s  Declaration  for  Section  II  Lithium  Cells  /  Batteries  
 

WARNING:  LITHIUM  BATTERIES  IDENTIFIED  BY  THE  MANUFACTURER  AS  BEING  DEFECTIVE  FOR  SAFETY  
REASONS,  OR  THAT  HAVE  BEEN  DAMAGED,  MUST  NOT  BE  SHIPPED  BY  AIR.  
Shipment  Details:  
Insert  MAWB  #  if  it  is  a  direct  
Master  Air  Waybill  Number:  _______________________  
Origin  
________________________  
shipment;  
if  n(Optional):  
ot,  insert  H_
AWB  
#.  
(For  Direct  Shipment)  

House  Air  Waybill  Number:  ________________________  Destination  (Optional):  ____________________  
(If  applicable)  
  Shipper’s  Information:    
Consignee’s  Details:  
  Name:        __________________________________  
Name:        __________________________________  
 
Address:    __________________________________  
Address:    __________________________________  
Insert  Company  Name,  
Insert  Company  Name,  
 
 
     __________________________________  
 
     __________________________________  
Address  
a
nd  
C
ontact  
N
umber  
Address  and  Contact  Number  
 
 
     __________________________________  
 
     __________________________________  
 
  Contact  Number:  ___________________________
 
  applicable  battery  type(s)  and  fill  in  the  blanks:  
Select  
the  
 

Contact  Number:  ___________________________  

Battery  Type  [IMP  Code]  

 
¨
¨  
¨  
¨
¨  
¨  

UN3480  PI965  [ELI]  

Lithium  Ion  Cells  /  Batteries  
ONLY  

Pieces  

Cell  /  Battery  ≤  2.7Wh  
 
Insert  the  number  
Cell    >  2.7Wh  but  ≤  20Wh  
of  packages  of  e ach    
 
Battery  >  2.7Wh  but  ≤  battery.  
100Wh  
 

UN3481  PI966  [ELI]  

Ion  Cells  /  Batteries  Packed  with  Equipment  
Check  tLithium  
he  box(es)  
UN3481  PI967  [ELI]  
for  the  
Lithium  
I
on  
C
ells  
/  Batteries  Contained  in  Equipment  
appropriate  
Cell  /  Battery  ≤  0.3g  lithium  content  
battery  
type(s).  
UN3090  
PI968  [ELM]  

 
 

Lithium  Metal  Cells  /  Batteries   Cell    >  0.3g  but  ≤  1g  lithium  content  
ONLY  
Battery  >  0.3g  but  ≤  2g  lithium  content  

 

UN3091  PI969  [ELM]  

 

Lithium  Metal  Cells  /  Batteries  Packed  with  Equipment  

 

Net  Weight    
per  Package  (kg)  

State     the  NET  WEIGHT  of  each  
individual  
package    
 
OR    
Declare  that  the  NET  WEIGHT  of  
 
each  individual  package  does  not  
exceed  
  certain  kg  /  net  quantity  
limit  of  the  relevant  PI  (see  
sample  
  for  details)  
 
 
**For  Overpack,  state  clearly  the  
 
words  “Overpack  used”,  number  
 
of  package  
and  the  NET  weight  of  
each  package.  
(If  not  
  enough  space,  details  shown  

 
UN3091  PI970  [ELM]  
on  supplementary  paper  is  
Lithium  Metal  Cells  /  Batteries  Contained  in  Equipment  
acceptable)  
¨ Lithium  ION  batteries  in  compliance  with  Section  II  of  PI    
 .    
¨ Lithium  METAL  batteries  in  compliance  with  Section  II  of  PI    
.    
• This  package  must  be  handled  with  care  and  that  a  flammability  hazard  eState  
xists  itf  he  
the  
package  is  dPamaged.  
 
appropriate  
acking  Instruction  
• Special  procedures  must  be  followed  in  the  event  the  package  is  damaged,  
t
o  
i
nclude  
i
nspection  
a
nd  
r
epacking  
#  of  the  selected  battery  type(s).  
if  necessary.    
Special  Procedures:     Specify  the  special  procedures  to  be  followed  when  the  package  is  damaged.  If  the  
   
 
 
 
  (even    under  the  
  same    MAWB    /  HAWB)  
  contains  
  batteries  
 
  different  
 
consignment  
w ith  
   
 
 
  procedures  
 
 
  information,  
 
  please  u
  se  separate  
 
 
special  
a   nd  contacts  
for     additional  
forms.  
   
 
 
 
 
 
 
 
 
 
 
 
 
 
• Telephone  Number  for  Additional  Information:  _____________________________________________  
he  
phone  
number    of  the  person  
(Country  Code)  +  Provide  
Area  Code  +t  P
hone  
Number  
who  is  knowledgeable  about  the  batteries.  
• Remarks:  
Additional  
if     needed  
                   
 
 
  information  
 
 
Name:      
 
 
 
 
 
(CAPITAL  
 
L
ETTERS)  
(e.g.  MSDS  Number).  
Date:        
 
 
 
 
 
                                                                                           

Updated  16  January  2015  

 


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