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FEDERAL AVIATION

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posted:
11/9/2011
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Transportation Security

Administration

Shipper’s Security Endorsement



“I certify that this shipment does not contain any unauthorized explosives,

destructive devices, or hazardous materials. I consent to a search of this shipment.

I am aware that this endorsement and original signature, along with other

shipping documents, will be retained on file for at least thirty days “





Shipper’s / Company Name: Date:





Signature of Shipper or

Authorized Representative:

Print / Type Name of Individual

Whose Signature Appears as

Shipper or Authorized

Representative:



Matching Photo on ID Indicate: YES NO

Type of first personal

Identification reviewed:



Number appearing on ID:







Type of second personal ID

Reviewed(if first was not a

Government issued photo ID:

Matching Photo ID? Indicate: YES NO

Number appearing on ID:



Name of person from whom

Shipment was accepted, if

Different from the shipper:



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