Use this simplified form to itemize up to 10 articles. Hazardous material information areas. Includes Memorandum Copy for agent’s or shipper’s files.
Hazardous material check-off column highlighted with red symbol. Emergency response phone number box with red printing. For ten or fewer items. Carbonless Triplicate. Form Size: 7 x 8 1/2, Forms Per Page: 1, Number of Entry Lines: 10, Form Quantity: 250.