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COPY FOR SENDER / EXEMPLAIRE DE L´EXPEDITEUR
1 Sender / Expéditeur INTERNATIONAL CONSIGNMENT NOTE LETTRE DE VOITURE INTERNATIONALE This carriage is subject notwithstanding any clause to the contrary to de Convention on the Contract for the International Carriage of Goods by Road (CMR) Ce transport est soumis, nonobstant toute clause contraire à la Convention au Contrat de Transport International de Marchandises par Route (CMR)
2 Consignee / Destinataire 16. Carrier / Transporteur
3 Place of delivery of the goods / Lieu pour la livraison de la marchandise 17. Successive Carriers / Transporteurs succesifs
4 Loading place of the goods / Lieu de la prise en charge de la marchandise 18. Carrier´s reservations and observations / Réserves et observations du transporteur
5 Documents attached / Documents annexés
6. Marks and numbers
Marques et numéros
7 Number of packages
Nombre de colis
8 Method of packing
Mode d´emballage
9 Nature of the goods
Nature de la marchandise
10. Statist. No
No Statist.
11. Gross weight, kg
Poids brut, kg
12 Volume m3
Cubage m3
13 Sender´s Instructions / Instructions d l´expéditeur 19. Special agreements / Conventions Particulières
20 To be paid by
A payer par
Sender / Expéditeur Consignee / Destinataire
Carriage charges Prix du transport
Reductions Réductions
Balance Solde
Supplem. charges Suppléments
14 Instruction as to payment for carriage / Instructions de paiment pour le
transport
Other charges Frais accesoires
Seguro Assurance
TOTAL
21 Established in ..... on .... / Etablie à ...... le........ 15 Cash on delivery /Remboursement
22
Signature and stamp of the sender Signature et timbre de l´expéditeur
23 Signature and stamp of the carrier Signature et timbre du transporteur
24 Goods received / Merchandises reçues
Place on Lieu à Signature and stamp of the consignee Signature et timbre du destinataire
Sample Document
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International Trade and Transport Documents
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