Manifest Form 10

Sender Name :		Sender's Authorization No :
Sender Address :		Manifest Document No :
City :	Dist :	Sender's Phone No :
Pin code :	State:	Sender's Email ID :

Transporter Name :		Transporter's Reg. No :
Transporter Address :		Vehicle Reg No.:	Vehicle Type:
City :	Dist :	Transporter's Phone No :
Pin code :	State:	Transporter's Email ID :

Receiver Name :
Receiver Address :		Receiver's Authorization No :
City :	Dist :	Receiver's Phone No :
Pin code :	State:	Receiver's Email ID :

Waste Description :
Total Quantity :	MT No. of Containers: Nos	Physical Form :
Special handling instructions & additional information :
UBIN (if any) :
Sender's Certificate	I hereby declare that the contents of the consignment are fully and accurately described above by proper shipping name and are categorised, packed, marked and labelled and are in all respects in proper conditions for transport by road according to applicable national government regulations.