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1. Sender (name, address, country)
INTERNATIONAL CONSIGNMENT NOTE
This carriage is subject notwithstanding any clause to the contary, to the Convention on the Contact for the International Carriage of goods by road (CMR)
2. Consignee (name, address, country)
16. Carrier (name, address, country)
3. Place of delivery of the goods (place, country)
17. Successive carriers (name, address, country)
4.Place and date of taking over the goods (place, country, date)
18. Carrier's reservations and obserations
5. Annexed documents
6. Marks and numbers
7. Number of packages
8. Method of packing
9. Nature of the goods
10. Statistical number
11. Gross weight kg
12. Volume m3
Class
Number
Letter
ADR
Σ
13 Sender's instructions (Customs and other formalities)
19 Special agreements
20 To be paid bySenderConsignee
Carriage charges
Reductions
Balance
Supplement charges
Miscellaneous
Total to be Paid
14 Directions as to freight payment
21 Established in/on
15 Cash on delivery
22 Signature and stamp of the sender
23 Signature and stamp of the carrier
22 Signature and stamp of the sender
Available with subscription
23 Signature and stamp of the carrier
Available with subscription
24 Tractor license plate Trailer license plate
 
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