Письмо Минтранса РФ от 24 мая 2010 г. N ОБ-16/5460

О формах транспортных (товаросопроводительных) документов, которые могут использоваться при перемещении товаров в Таможенном союзе

Министерство транспорта Российской Федерации рассмотрело письмо Федеральной налоговой службы от 14.04.2010 N 3-1-05/284 относительно представления образцов форм транспортных (товаросопроводительных) документов, которые могут использоваться хозяйствующими субъектами Российской Федерации при перемещении товаров в Таможенном союзе с территории Российской Федерации на территорию Республики Казахстан и (или) Республики Беларусь (с территории Республики Казахстан и (или) Республики Беларусь при оказании услуг по перевозке товаров российскими перевозчиками), в том числе, с использованием автомобильного, железнодорожного, воздушного транспорта, и сообщает следующее.

При перемещении товаров в Таможенном союзе по территориям указанных республик с использованием автомобильного транспорта хозяйствующими субъектами Российской Федерации может использоваться форма 1-Т "Товарно-транспортная накладная", утвержденная Постановлением Государственного комитета Российской Федерации по статистике от 28.11.1997 N 78 "Об утверждении унифицированных форм первичной учетной документации по учету работы строительных машин и механизмов, работ в автомобильном транспорте".

При оказании услуг с использованием воздушного транспорта хозяйствующими субъектами Российской Федерации могут использоваться следующие транспортные документы, подлежащие в соответствии с пунктом 2 статьи 105 Воздушного кодекса Российской Федерации от 19.03.1997 N 60-ФЗ обязательному применению для удостоверения договоров воздушной перевозки грузов и утвержденные письмом Министерства финансов Российской Федерации от 29.05.1998 N 16-00-27-23:

нейтральная грузовая накладная для оформления внутренних и международных воздушных перевозок грузов;

грузовая накладная перевозчика для оформления внутренних и международных воздушных перевозок грузов.

При перемещении товаров в Таможенном союзе железнодорожным транспортом хозяйствующими субъектами Российской Федерации могут использоваться формы транспортных (товаросопроводительных) документов, приведенные в Приложении 12.1, 12.2, 12.3, 12.4 Служебной инструкции к Соглашению о Международном Железнодорожном Грузовом Сообщении (СМГС, действует с 1 ноября 1951 г. с изменениями и дополнениями на 1 июля 2009 г.).

Приложение:

1. Форма 1-Т "Товарно-транспортная накладная".

2. Нейтральная грузовая накладная для оформления внутренних и международных воздушных перевозок грузов.

3. Грузовая накладная перевозчика для оформления внутренних и международных воздушных перевозок грузов.

4. Образцы накладных СМГС.

Примечание. Приложение 2 и 3 не приводится. См. Стандарты ИАТА по заполнению авианакладной РЕЗОЛЮЦИЯ 600А АВИАНАКЛАДНАЯ

О.В.БЕЛОЗЕРОВ

См. также:

Письмо ФНС от 29 июня 2010 г. N ШС-37-3/5424@ Об образцах форм транспортных (товаросопроводительных) документов

Инструкцию о порядке оформления международной товарно-транспортной накладной "CMR", утв. Постановлением Министерства транспорта и коммуникаций Республики Беларусь от 20.02.2012 N 11

Приложение N 1

Типовая межотраслевая форма N 1-Т

Утверждена Постановлением

Госкомстата России

от 28.11.97 N 78

                                                                                                                         +------------------+

                                                                                                                         |       Коды       |
                                                                                                                         +------------------+

                                                                                                           Форма по ОКУД |      0345009     |
                                                                                                                         +------------------+

                                              ТОВАРНО-ТРАНСПОРТНАЯ НАКЛАДНАЯ                               ___________ N |                  |
                                                                                                             (серия)     +-----+------+-----+

                                                                                                        Дата составления |     |      |     |
                                                                                                                         +-----+------+-----+

Грузоотправитель _______________________________________________________________________________________________ по ОКПО |                  |
                                    (полное наименование организации, адрес, номер телефона)                             |                  |
                                                                                                                         +------------------+

Грузополучатель  _______________________________________________________________________________________________ по ОКПО |                  |
                                    (полное наименование организации, адрес, номер телефона)                             |                  |
                                                                                                                         +------------------+

Плательщик       _______________________________________________________________________________________________ по ОКПО |                  |
                                 (полное наименование организации, адрес, банковские реквизиты)                          |                  |
                                                                                                                         +------------------+

                                     1. ТОВАРНЫЙ РАЗДЕЛ (заполняется грузоотправителем)

+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

| Код продукции  |   Номер    |Артикул или |Количество|Цена,|Наименование| Единица |  Вид   |Количество| Масса, т |Сумма,| Порядковый номер |
|(номенклатурный)|прейскуранта|  номер по  |          |руб. | продукции, |измерения|упаковки|   мест   |          | руб. |    записи по     |
|                |и дополнения|прейскуранту|          |коп. |   товара   |         |        |          |          | коп. |    складской     |
|                |   к нему   |            |          |     |  (груза),  |         |        |          |          |      |    картотеке     |
|                |            |            |          |     | ТУ, марка, |         |        |          |          |      |(грузоотправителю,|
|                |            |            |          |     |размер, сорт|         |        |          |          |      | грузополучателю) |
+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

|       1        |     2      |     3      |    4     |  5  |     6      |    7    |   8    |    9     |    10    |  11  |        12        |
+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

|                |            |            |          |     |            |         |        |          |          |      |                  |
+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

|                |            |            |          |     |            |         |        |          |          |      |                  |
+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

|                |            |            |          |     |            |         |        |          |          |      |                  |
+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

|                |            |            |          |     |            |         |        |          |          |      |                  |
+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

|                |            |            |          |     |            |         |        |          |          |      |                  |
+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

|                |            |            |          |     |            |         |        |          |          |      |                  |
+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

|                |            |            |          |     |            |         |        |          |          |      |                  |
+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

|                |            |            |          |     |            |         |        |          |          |      |                  |
+----------------+------------+------------+----------+-----+------------+---------+--------+----------+----------+------+------------------+

Товарная накладная имеет продолжение на ____________ листах, на бланках за N _________________________ |Наценка, %|      |
и содержит _________________________________________ порядковых номеров записей                        +----------+------+

                         (прописью)                                                   +------------+   |Складские |      |
Всего наименований _________________________________ Масса груза (нетто) ____________ |            | т |или транс-|      |
                              (прописью)                                  (прописью)  +------------+   |портные   |      |
Всего мест _________________________________________ Масса груза (брутто) ___________ |            | т |расходы   |      |
                         (прописью)                                        (прописью) +------------+   +----------+------+

                                                                                                       |          |      |
                                                                                                       +----------+------+

                                                                                                       |  Всего   |      |
                                                                                                       | к оплате |      |
                                                                                                       +----------+------+

                                                                          |
Приложение (паспорта, сертификаты и т.п.) на ____________ листах _________|По доверенности N ______ от "__" ________ ____ г.

                                              (прописью)                  |выданной _________________________________________________________

Всего отпущено на сумму _________________________________ руб. ___ коп.   |Груз к перевозке принял _____________ ___________ ________________

                                   (прописью)                             |                         (должность)   (подпись)    (расшифровка

                                                                          |                                                       подписи)

Отпуск разрешил                    Главный (старший)                      |
_____________ __________ _________ бухгалтер        ___________ __________|(При личном приеме товара по количеству и ассортименту)

 (должность)   (подпись) (расшиф-                    (подпись)   (расшиф- |__________________________________________________________________

                         ровка                                   ровка    |
                         подписи)                                подписи) |Груз получил грузополучатель _____________ __________ _____________

                                                                          |                              (должность)   (подпись) (расшифровка

Отпуск груза произвел _____________ ___________ ________________________  |                                                         подписи)

                       (должность)   (подпись)    (расшифровка подписи)   |
                                                                          |
                               М.П.    "__" ____________ ____ г.          |
                                                                          |

                                              Оборотная сторона формы N 1-Т

                                                2. ТРАНСПОРТНЫЙ РАЗДЕЛ

                                                                                                         +-------------+

Регистрационный N _____ Серия ______ N _____                                                       ТТН N |             |
Срок доставки груза "__" _________ ____ г.                                                               |             |
                                                                                                         +-------------+

Организация ________________________ Автомобиль _________ Государственный номерной знак ___   К путевому |             |
             (наименование, адрес,               (марка)                                         листу N |             |
                номер телефона,                                                                          |             |
             банковские реквизиты)                                                                       |             |
                                                                                                         +-------------+

Заказчик (плательщик) __________________________________________________________________________________ |             |
                                (наименование, адрес, номер телефона, банковские реквизиты)              |             |
                                                                                                         +-------------+

Водитель __________________________ Удостоверение N ____________________________________________________ |             |
          (фамилия, имя, отчество)                                                                       |             |
                       стандартная, ограниченная                                                         |             |
Лицензионная карточка --------------------------- Вид перевозки ____________________________________ Код |             |
                         (ненужное зачеркнуть)                                                           +-------------+

Регистрационный N __________ Серия _________ N __________                                                |             |
Пункт погрузки _________________________ Пункт разгрузки _______________________________________ Маршрут |             |
                (адрес, номер телефона)                          (адрес, номер телефона)                 +-------------+

Переадресовка ________________________________ 1. Прицеп _________ Государственный ______ Гаражный номер |             |
               (наименование и адрес нового               (марка)  номерной знак                         |             |
                  грузополучателя, номер                                                                 |             |
                     распоряжения)                                                                       |             |
_______________________________                2. Прицеп _________ Государственный ______ Гаражный номер |             |
 (подпись ответственного лица)                            (марка)  номерной знак                         |             |
                                                                                                         +-------------+

                             СВЕДЕНИЯ О ГРУЗЕ

+---------------------+--------------------+------------+----------+----------------------+------+----------+--------+--------+

|Краткое наименование |  С грузом следуют  |    Вид     |Количество|  Способ определения  | Код  |  Номер   | Класс  | Масса  |
|        груза        |     документы      |  упаковки  |   мест   |        массы         |груза |контейнера| груза  |брутто, |
|                     |                    |            |          |                      |      |          |        |   т    |
+---------------------+--------------------+------------+----------+----------------------+------+----------+--------+--------+

|          1          |         2          |     3      |    4     |          5           |  6   |    7     |   8    |   9    |
+---------------------+--------------------+------------+----------+----------------------+------+----------+--------+--------+

|1.                   |                    |            |          |                      |      |          |        |        |
+---------------------+--------------------+------------+----------+----------------------+------+----------+--------+--------+

|2.                   |                    |            |          |                      |      |          |        |        |
+---------------------+--------------------+------------+----------+----------------------+------+----------+--------+--------+

|3.                   |                    |            |          |                      |      |          |        |        |
+---------------------+--------------------+------------+----------+----------------------+------+----------+--------+--------+

Указанный груз               Кол-во           |Указанный груз       Кол-во      Количество|      |Итого: масса       |        |
с исправной пломбой,         мест ____________|с исправной          мест ______ ездок,    |      |брутто, г          |        |
тарой и упаковкой __________       (прописью) |пломбой, тарой            (про-  заездов   +------+                   +--------+

                   (оттиск)                   |и упаковкой ________      писью)     |
                                              |            (оттиск)                 |
Массой брутто ____________ т   к перевозке    |Массой брутто ____________ т         |Отметки о составленных актах _____________

               (прописью)                     |               (прописью)            |
                                              |сдал водитель-                       |Транспортные услуги ______________________

Сдал _____________ ___________ ______________ |экспедитор ___________ ______________|__________________________________________

      (должность)   (подпись)   (расшифровка  |            (подпись)   (расшифровка |
                                  подписи)    |                          подписи)   |
                                              |                               место |
Принял водитель-                       место  |Принял ______ _____ _________   для  |
экспедитор ___________ ______________   для   |       (долж- (под- (расшиф-   штампа|
            (подпись)   (расшифровка   штампа |       ность) пись) ровка            |
                          подписи)            |                    подписи)         |

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                 ПОГРУЗОЧНО-РАЗГРУЗОЧНЫЕ ОПЕРАЦИИ                                            |
+---------+--------------+--------------+-----------------+---------------------+--------------------+--------------+---------+

|операция | исполнитель  |дополнительные|    механизм,    |       способ        |дата (число, месяц),|    время     |подпись  |
|         |(автовладелец,|   операции   |грузоподъемность,|                     |   время, ч, мин.   |дополнительных|ответст- |
|         | получатель,  |(наименование,|  емкость ковша  +-----------------+---+-----------+--------+операций, мин.|венного  |
|         | отправитель) | количество)  |                 |     ручной,     |код| прибытия  | убытия |              |лица     |
|         |              |              |                 |механизированный,|   |           |        |              |         |
|         |              |              |                 |    наливом,     |   |           |        |              |         |
|         |              |              |                 |   самосвалом    |   |           |        |              |         |
+---------+--------------+--------------+-----------------+-----------------+---+-----------+--------+--------------+---------+

|   10    |      11      |      12      |       13        |       14        |15 |    16     |   17   |      18      |   19    |
+---------+--------------+--------------+-----------------+-----------------+---+-----------+--------+--------------+---------+

|погрузка |              |              |                 |                 |   |           |        |              |         |
+---------+--------------+--------------+-----------------+-----------------+---+-----------+--------+--------------+---------+

|разгрузка|              |              |                 |                 |   |           |        |              |         |
+---------+--------------+--------------+-----------------+-----------------+---+-----------+--------+--------------+---------+

+-----------------------------------------------------------------------------------------------------+

|               ПРОЧИЕ СВЕДЕНИЯ (заполняется организацией, владельцем автотранспорта)                 |Таксировка: ____________

+----------------------+------+-------------------+------------+-----------------+--------------------+________________________

| расстояние перевозки |код   |  за транспортные  |сумма штрафа|   поправочный   |   время простоя,   |________________________

| по группам дорог, км |экспе-|      услуги       |     за     |   коэффициент   |      ч, мин.       |________________________

|                      |диро- |                   |неправильное|                 |                    |________________________

+-----+----+---+---+---+вания +-------+-----------+ оформление +--------+--------+---------+----------+________________________

|всего| в  | I |II |III|груза |   с   |причитается|документов, |расценка|основной|   под   |   под    |________________________

|     |гор.|гр.|гр.|гр.|      |клиента| водителю  | руб. коп.  |водителю| тариф  |погрузкой|разгрузкой|________________________

|     |    |   |   |   |      |       |           |            |        |        |         |          |________________________

|     |    |   |   |   |      |       |           |            |        |        |         |          |________________________

|     |    |   |   |   |      |       |           |            |        |        |         |          |________________________

+-----+----+---+---+---+------+-------+-----------+------------+--------+--------+---------+----------+________________________

| 20  | 21 |22 |23 |24 |  25  |  26   |    27     |     28     |   29   |   30   |   31    |    32    |________________________

+-----+----+---+---+---+------+-------+-----------+------------+--------+--------+---------+----------+________________________

|     |    |   |   |   |      |       |           |            |        |        |         |          |________________________

+-----+----+---+---+---+------+-------+-----------+------------+--------+--------+---------+----------+________________________

+---------+-----+------+------------+----------+------+------------------+------+------+----+-----+____________________________

|  Расчет | За  |  За  |Погрузочно- |Недогрузка|Экспе-| Сверхнормативный |За    |За    |Про-|Всего|____________________________

|стоимости|тонны|тонно-|разгрузочные|автомобиля|диро- | простой, ч, мин. |сроч- |специ-|чие |     |____________________________

|         |     |  км  |  работы,   |и прицепа |вание |       при        |ность |альный|доп-|     |____________________________

|         |     |      |    тонн    |          |      +--------+---------+заказа|транс-|латы|     |____________________________

|         |     |      |            |          |      |погрузке|разгрузке|      |порт  |    |     |____________________________

|         |     |      |            |          |      |        |         |      |      |    |     |Таксировщик ______ _________

|         |     |      |            |          |      |        |         |      |      |    |     |            (под-  (расшиф-

|         |     |      |            |          |      |        |         |      |      |    |     |            пись)  ровка

|         +-----+------+------------+----------+------+--------+---------+------+------+----+-----+                   подписи)

|         | 33  |  34  |     35     |    36    |  37  |   38   |   39    |  40  |  41  | 42 | 43  |
+---------+-----+------+------------+----------+------+--------+---------+------+------+----+-----+

|Выполнено|     |      |            |          |      |        |         |      |      |    |     |
+---------+-----+------+------------+----------+------+--------+---------+------+------+----+-----+

|Расценка,|     |      |            |          |      |        |         |      |      |    |     |
|руб. коп.|     |      |            |          |      |        |         |      |      |    |     |
+---------+-----+------+------------+----------+------+--------+---------+------+------+----+-----+

|К оплате,|     |      |            |          |      |        |         |      |      |    |     |
|руб. коп.|     |      |            |          |      |        |         |      |      |    |     |
+---------+-----+------+------------+----------+------+--------+---------+------+------+----+-----+

Приложение N 4

Приложения 12.1 и 12.2

(к § 1 статьи 7)

ОБРАЗЦЫ

НАКЛАДНЫХ СМГС <*>

--------------------------------

<*> При тиражировании настоящих бланков графа 50 об опасных грузах может иметь рамку и слова "Прил. 2" красного или черного цвета.

- для перевозки малой скоростью (12.1)

- для перевозки большой скоростью (12.2)

Оригинал накладной                                              +--+--+--+---+---+---+---+---+

(для получателя)                                                |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+   25    Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|  1 |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|малой|                |               +---------------+        +----------------+            |               |               |
|ско- |                |               | | | | | | | | |                         |            |               |               |
|рости|                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|     |                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+-----------------------------+---+---+-+-----------+-----+-------+------------+---------------------------+--------------------------+

|53 Сообщение                 |   |   | |60         |61   |62     |63          |68 Расчеты с отправителем  |69 Расчеты с получателем  |
|                             | | | | | |N позиции  |Класс|Ставка |Расчетная   +-------------+-------------+-------------+------------+

|                             +-+-+-+-+-+           |     |       |масса (кг)  |70 Сумма в   |71 Сумма в   |72 Сумма в   |73 Сумма в  |
|                                       |           |     |       |            |   .......   |   .......   |   .......   |   .......  |
+--+------------------------------------+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+------------+

|54|Провозная                           | | | | | | |  |  | | | | |            |74           |75           |76           |            |
+--+плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|-------------|-------------|            |
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+-------------+-------------+            |
|                   |  |  |=                                              +  > |78           |79           |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|55|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|56|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|57|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|58|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|59|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |77          |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|             |-------------|------------|
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+             +-------------+------------+

|                   |  |  |=                                              +  > |78           |             |80           |81          |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+------+-+-+-+-+-+---------+-+-+-+-+      |_____________|_____________|_____________|____________|
|90 Курс пересчета                                                      |      |_____________|_____________|_____________|____________|
+----------------------------------+------------------------------------+------+-------------+-------------+-------------+------------+

|   дороги отправления             |дороги назначения                   |Всего |86           |87           |88           |89          |
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
+----------------------------------+----+-------------------------------+------+-------------+-------------+-------------+------------+

|91 Отметки о расчетах платежей         |87 Всего взыскать с отправителя (прописью)                             Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |89 Всего взыскать с получателя (прописью)                              Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |92 Дополнительно взыскать с отправителя за                        ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
+---------------------------------------+---------------------------------------------------------------------------------------------+

Дорожная ведомость                                              +--+--+--+---+---+---+---+---+

(для дороги назначения)                                         |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+   25    Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|  2 |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|малой|                |               +---------------+        +----------------+            |               |               |
|ско- |                |               | | | | | | | | |                         |            |               |               |
|рости|                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|     |                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+-----------------------------+---+---+-+-----------+-----+-------+------------+---------------------------+--------------------------+

|53 Сообщение                 |   |   | |60         |61   |62     |63          |68 Расчеты с отправителем  |69 Расчеты с получателем  |
|                             | | | | | |N позиции  |Класс|Ставка |Расчетная   +-------------+-------------+-------------+------------+

|                             +-+-+-+-+-+           |     |       |масса (кг)  |70 Сумма в   |71 Сумма в   |72 Сумма в   |73 Сумма в  |
|                                       |           |     |       |            |   .......   |   .......   |   .......   |   .......  |
+--+------------------------------------+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+------------+

|54|Провозная                           | | | | | | |  |  | | | | |            |74           |75           |76           |            |
+--+плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|-------------|-------------|            |
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+-------------+-------------+            |
|                   |  |  |=                                              +    |78           |79           |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|55|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +    |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|56|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +    |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|57|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +    |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|58|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +    |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|59|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |77          |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|             |-------------|------------|
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+             +-------------+------------+

|                   |  |  |=                                              +    |78           |             |80           |81          |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+------+-+-+-+-+-+---------+-+-+-+-+      |_____________|_____________|_____________|____________|
|90 Курс пересчета                                                      |      |_____________|_____________|_____________|____________|
+----------------------------------+------------------------------------+------+-------------+-------------+-------------+------------+

|   дороги отправления             |дороги назначения                   |Всего |86           |87           |88           |89          |
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
+----------------------------------+----+-------------------------------+------+-------------+-------------+-------------+------------+

|91 Отметки о расчетах платежей         |87 Всего взыскать с отправителя (прописью)                             Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |89 Всего взыскать с получателя (прописью)                              Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |92 Дополнительно взыскать с отправителя за                        ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
+---------------------------------------+---------------------------------------------------------------------------------------------+

Дубликат накладной                                              +--+--+--+---+---+---+---+---+

(для отправителя)                                               |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+         Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|  3 |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|малой|                |               +---------------+        +----------------+            |               |               |
|ско- |                |               | | | | | | | | |                         |            |               |               |
|рости|                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|     |                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+-----------------------------+---+---+-+-----------+-----+-------+------------+---------------------------+--------------------------+

|53 Сообщение                 |   |   | |60         |61   |62     |63          |68 Расчеты с отправителем  |69 Расчеты с получателем  |
|                             | | | | | |N позиции  |Класс|Ставка |Расчетная   +-------------+-------------+-------------+------------+

|                             +-+-+-+-+-+           |     |       |масса (кг)  |70 Сумма в   |71 Сумма в   |72 Сумма в   |73 Сумма в  |
|                                       |           |     |       |            |   .......   |   .......   |   .......   |   .......  |
+--+------------------------------------+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+------------+

|54|Провозная                           | | | | | | |  |  | | | | |            |74           |75           |76           |            |
+--+плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|-------------|-------------|            |
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+-------------+-------------+            |
|                   |  |  |=                                              +  > |78           |79           |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|55|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|56|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|57|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|58|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|59|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |77          |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|             |-------------|------------|
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+             +-------------+------------+

|                   |  |  |=                                              +  > |78           |             |80           |81          |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+------+-+-+-+-+-+---------+-+-+-+-+      |_____________|_____________|_____________|____________|
|90 Курс пересчета                                                      |      |_____________|_____________|_____________|____________|
+----------------------------------+------------------------------------+------+-------------+-------------+-------------+------------+

|   дороги отправления             |дороги назначения                   |Всего |86           |87           |88           |89          |
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
+----------------------------------+----+-------------------------------+------+-------------+-------------+-------------+------------+

|91 Отметки о расчетах платежей         |87 Всего взыскать с отправителя (прописью)                             Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |89 Всего взыскать с получателя (прописью)                              Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |92 Дополнительно взыскать с отправителя за                        ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
+---------------------------------------+---------------------------------------------------------------------------------------------+

Лист выдачи груза                                               +--+--+--+---+---+---+---+---+

(для дороги назначения)                                         |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+         Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|  4 |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|малой|                |               +---------------+        +----------------+            |               |               |
|ско- |                |               | | | | | | | | |                         |            |               |               |
|рости|                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|     |                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+----------------------------------------------------------------------------------+

|93 Отметки железной дороги                                                        |
|                                                                                  |
|                                                                                  |
|                                                                                  |
+------------------------------------------+------------------------+--------------+

|94 Коммерческий акт                       |  Календарный штемпель  |97 Уведомление|
+------------------------------------------+                        |   получателя |
|   Коммерческий акт N .........             дата .........         |   о прибытии |
|                                                                   |   груза      |
|   Составлен станцией ................                             |              |
|                                                                   |              |
|   Составлен по причине ................                           |              |
|                                                                   +--------------+

|   Подпись ...........................                             |98 Выдача     |
+-------------------------------------------------------------------+   груза      |
|95 Удлинение срока доставки                                        |   получателю |
+----------------------------------+--------------------------------+              |
|   Станция .......................|  Станция ......................|              |
|   Задержка из-за                 |  Задержка из-за                |              |
|                                  |                                +--------------+

|__________________________________|________________________________|Груз получил  |
|__________________________________|________________________________|(подпись,     |
|__________________________________|________________________________|дата)         |
|                                  |                                |              |
|   от ........... час ............|  от ........... час ...........|              |
|                                  |                                |              |
|   до ........... час ............|  до ........... час ...........|              |
+----------------------------------+--------------------------------+--------------+

|96 Штемпель пограничных станций перехода                                          |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

Лист уведомления о прибытии груза                               +--+--+--+---+---+---+---+---+

(для получателя)                                                |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+         Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|  5 |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|малой|                |               +---------------+        +----------------+            |               |               |
|ско- |                |               | | | | | | | | |                         |            |               |               |
|рости|                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|     |                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+----------------------------------------------------------------------------------+

|93 Отметки железной дороги                                                        |
|                                                                                  |
|                                                                                  |
|                                                                                  |
+------------------------------------------+------------------------+--------------+

|94 Коммерческий акт                       |  Календарный штемпель  |              |
+------------------------------------------+                        |              |
|   Коммерческий акт N ......... дата .........                     |              |
|                                                                   |              |
|   Составлен станцией ................                             |              |
|                                                                   |              |
|   Составлен по причине ................                           |              |
|                                                                   |              |
|   Подпись ...........................                             |              |
+-------------------------------------------------------------------+              |
|95 Удлинение срока доставки                                        |              |
+----------------------------------+--------------------------------+              |
|   Станция .......................|  Станция ......................|              |
|   Задержка из-за                 |  Задержка из-за                |              |
|                                  |                                |              |
|__________________________________|________________________________|              |
|__________________________________|________________________________|              |
|__________________________________|________________________________|              |
|                                  |                                |              |
|   от ........... час ............|  от ........... час ...........|              |
|                                  |                                |              |
|   до ........... час ............|  до ........... час ...........|              |
+----------------------------------+--------------------------------+--------------+

|96 Штемпель пограничных станций перехода                                          |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

Оригинал накладной                                              +--+--+--+---+---+---+---+---+

(для получателя)                                                |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+25       Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|  1 |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|боль-|                |               +---------------+        +----------------+            |               |               |
|шой  |                |               | | | | | | | | |                         |            |               |               |
|ско- |                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|рости|                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

+-------------------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                                     |
+-------------------------------------------------------------------------------------------------------------------------------------+

+-----------------------------+---+---+-+-----------+-----+-------+------------+---------------------------+--------------------------+

|53 Сообщение                 |   |   | |60         |61   |62     |63          |68 Расчеты с отправителем  |69 Расчеты с получателем  |
|                             | | | | | |N позиции  |Класс|Ставка |Расчетная   +-------------+-------------+-------------+------------+

|                             +-+-+-+-+-+           |     |       |масса (кг)  |70 Сумма в   |71 Сумма в   |72 Сумма в   |73 Сумма в  |
|                                       |           |     |       |            |   .......   |   .......   |   .......   |   .......  |
+--+------------------------------------+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+------------+

|54|Провозная                           | | | | | | |  |  | | | | |            |74           |75           |76           |            |
+--+плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|-------------|-------------|            |
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+-------------+-------------+            |
|                   |  |  |=                                              +  > |78           |79           |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|55|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|56|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|57|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|58|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|59|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |77          |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|             |-------------|------------|
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+             +-------------+------------+

|                   |  |  |=                                              +  > |78           |             |80           |81          |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+------+-+-+-+-+-+---------+-+-+-+-+      |_____________|_____________|_____________|____________|
|90 Курс пересчета                                                      |      |_____________|_____________|_____________|____________|
+----------------------------------+------------------------------------+------+-------------+-------------+-------------+------------+

|   дороги отправления             |дороги назначения                   |Всего |86           |87           |88           |89          |
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
+----------------------------------+----+-------------------------------+------+-------------+-------------+-------------+------------+

|91 Отметки о расчетах платежей         |87 Всего взыскать с отправителя (прописью)                             Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |89 Всего взыскать с получателя (прописью)                              Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |92 Дополнительно взыскать с отправителя за                        ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
+---------------------------------------+---------------------------------------------------------------------------------------------+

+-------------------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                                     |
+-------------------------------------------------------------------------------------------------------------------------------------+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

Дорожная ведомость                                              +--+--+--+---+---+---+---+---+

(для дороги назначения)                                         |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+25       Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|  2 |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|боль-|                |               +---------------+        +----------------+            |               |               |
|шой  |                |               | | | | | | | | |                         |            |               |               |
|ско- |                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|рости|                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

+-------------------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                                     |
+-------------------------------------------------------------------------------------------------------------------------------------+

+-----------------------------+---+---+-+-----------+-----+-------+------------+---------------------------+--------------------------+

|53 Сообщение                 |   |   | |60         |61   |62     |63          |68 Расчеты с отправителем  |69 Расчеты с получателем  |
|                             | | | | | |N позиции  |Класс|Ставка |Расчетная   +-------------+-------------+-------------+------------+

|                             +-+-+-+-+-+           |     |       |масса (кг)  |70 Сумма в   |71 Сумма в   |72 Сумма в   |73 Сумма в  |
|                                       |           |     |       |            |   .......   |   .......   |   .......   |   .......  |
+--+------------------------------------+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+------------+

|54|Провозная                           | | | | | | |  |  | | | | |            |74           |75           |76           |            |
+--+плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|-------------|-------------|            |
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+-------------+-------------+            |
|                   |  |  |=                                              +  > |78           |79           |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|55|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|56|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+Fuvardij                            |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|57|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|58|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|59|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |77          |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|             |-------------|------------|
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+             +-------------+------------+

|                   |  |  |=                                              +  > |78           |             |80           |81          |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+------+-+-+-+-+-+---------+-+-+-+-+      |_____________|_____________|_____________|____________|
|90 Курс пересчета                                                      |      |_____________|_____________|_____________|____________|
+----------------------------------+------------------------------------+------+-------------+-------------+-------------+------------+

|   дороги отправления             |дороги назначения                   |Всего |86           |87           |88           |89          |
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
+----------------------------------+----+-------------------------------+------+-------------+-------------+-------------+------------+

|91 Отметки о расчетах платежей         |87 Всего взыскать с отправителя (прописью)                             Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |89 Всего взыскать с получателя (прописью)                              Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |92 Дополнительно взыскать с отправителя за                        ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
+---------------------------------------+---------------------------------------------------------------------------------------------+

+-------------------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                                     |
+-------------------------------------------------------------------------------------------------------------------------------------+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

Дубликат накладной                                              +--+--+--+---+---+---+---+---+

(для отправителя)                                               |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+         Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|  3 |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|боль-|                |               +---------------+        +----------------+            |               |               |
|шой  |                |               | | | | | | | | |                         |            |               |               |
|ско- |                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|рости|                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

+-------------------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                                     |
+-------------------------------------------------------------------------------------------------------------------------------------+

+-----------------------------+---+---+-+-----------+-----+-------+------------+---------------------------+--------------------------+

|53 Сообщение                 |   |   | |60         |61   |62     |63          |68 Расчеты с отправителем  |69 Расчеты с получателем  |
|                             | | | | | |N позиции  |Класс|Ставка |Расчетная   +-------------+-------------+-------------+------------+

|                             +-+-+-+-+-+           |     |       |масса (кг)  |70 Сумма в   |71 Сумма в   |72 Сумма в   |73 Сумма в  |
|                                       |           |     |       |            |   .......   |   .......   |   .......   |   .......  |
+--+------------------------------------+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+------------+

|54|Провозная                           | | | | | | |  |  | | | | |            |74           |75           |76           |            |
+--+плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|-------------|-------------|            |
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+-------------+-------------+            |
|                   |  |  |=                                              +  > |78           |79           |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|55|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|56|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|57|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|58|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|59|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |77          |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|             |-------------|------------|
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+             +-------------+------------+

|                   |  |  |=                                              +  > |78           |             |80           |81          |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+------+-+-+-+-+-+---------+-+-+-+-+      |_____________|_____________|_____________|____________|
|90 Курс пересчета                                                      |      |_____________|_____________|_____________|____________|
+----------------------------------+------------------------------------+------+-------------+-------------+-------------+------------+

|   дороги отправления             |дороги назначения                   |Всего |86           |87           |88           |89          |
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
+----------------------------------+----+-------------------------------+------+-------------+-------------+-------------+------------+

|91 Отметки о расчетах платежей         |87 Всего взыскать с отправителя (прописью)                             Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |89 Всего взыскать с получателя (прописью)                              Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |92 Дополнительно взыскать с отправителя за                        ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
+---------------------------------------+---------------------------------------------------------------------------------------------+

+-------------------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                                     |
+-------------------------------------------------------------------------------------------------------------------------------------+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

Лист выдачи груза                                               +--+--+--+---+---+---+---+---+

(для дороги назначения)                                         |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+         Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|  4 |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|боль-|                |               +---------------+        +----------------+            |               |               |
|шой  |                |               | | | | | | | | |                         |            |               |               |
|ско- |                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|рости|                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

+----------------------------------------------------------------------------------+

|                                                                                  |
+----------------------------------------------------------------------------------+

+----------------------------------------------------------------------------------+

|93 Отметки железной дороги                                                        |
|                                                                                  |
|                                                                                  |
|                                                                                  |
+------------------------------------------+------------------------+--------------+

|94 Коммерческий акт                       |  Календарный штемпель  |97 Уведомление|
+------------------------------------------+                        |   получателя |
|   Коммерческий акт N .........             дата .........         |   о прибытии |
|                                                                   |   груза      |
|   Составлен станцией ................                             |              |
|                                                                   |              |
|   Составлен по причине ................                           |              |
|                                                                   +--------------+

|   Подпись ...........................                             |98 Выдача     |
+-------------------------------------------------------------------+   груза      |
|95 Удлинение срока доставки                                        |   получателю |
+----------------------------------+--------------------------------+              |
|   Станция .......................|  Станция ......................|              |
|   Задержка из-за                 |  Задержка из-за                |              |
|                                  |                                +--------------+

|__________________________________|________________________________|Груз получил  |
|__________________________________|________________________________|(подпись,     |
|__________________________________|________________________________|дата)         |
|                                  |                                |              |
|   от ........... час ............|  от ........... час ...........|              |
|                                  |                                |              |
|   до ........... час ............|  до ........... час ...........|              |
+----------------------------------+--------------------------------+--------------+

|96 Штемпель пограничных станций перехода                                          |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

+----------------------------------------------------------------------------------+

|                                                                                  |
+----------------------------------------------------------------------------------+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

Лист уведомления о прибытии груза                               +--+--+--+---+---+---+---+---+

(для получателя)                                                |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+         Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|  5 |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|боль-|                |               +---------------+        +----------------+            |               |               |
|шой  |                |               | | | | | | | | |                         |            |               |               |
|ско- |                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|рости|                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

+----------------------------------------------------------------------------------+

|                                                                                  |
+----------------------------------------------------------------------------------+

+----------------------------------------------------------------------------------+

|93 Отметки железной дороги                                                        |
|                                                                                  |
|                                                                                  |
|                                                                                  |
+------------------------------------------+------------------------+--------------+

|94 Коммерческий акт                       |  Календарный штемпель  |              |
+------------------------------------------+                        |              |
|   Коммерческий акт N ......... дата .........                     |              |
|                                                                   |              |
|   Составлен станцией ................                             |              |
|                                                                   |              |
|   Составлен по причине ................                           |              |
|                                                                   |              |
|   Подпись ...........................                             |              |
+-------------------------------------------------------------------+              |
|95 Удлинение срока доставки                                        |              |
+----------------------------------+--------------------------------+              |
|   Станция .......................|  Станция ......................|              |
|   Задержка из-за                 |  Задержка из-за                |              |
|                                  |                                |              |
|__________________________________|________________________________|              |
|__________________________________|________________________________|              |
|__________________________________|________________________________|              |
|                                  |                                |              |
|   от ........... час ............|  от ........... час ...........|              |
|                                  |                                |              |
|   до ........... час ............|  до ........... час ...........|              |
+----------------------------------+--------------------------------+--------------+

|96 Штемпель пограничных станций перехода                                          |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

|                               |                            |                     |
|                               |                            |                     |
|                               |                            |                     |
+-------------------------------+----------------------------+---------------------+

+----------------------------------------------------------------------------------+

|                                                                                  |
+----------------------------------------------------------------------------------+

Приложения 12.3 и 12.4

(к § 1 статьи 7)

ОБРАЗЦЫ

ДОПОЛНИТЕЛЬНЫХ ЭКЗЕМПЛЯРОВ ДОРОЖНЫХ ВЕДОМОСТЕЙ <*>

--------------------------------

<*> При тиражировании настоящих бланков графа 50 об опасных грузах может иметь рамку и слова "Прил. 2" красного или черного цвета.

- для перевозки малой скоростью (12.3)

- для перевозки большой скоростью (12.4)

Дорожная ведомость                                              +--+--+--+---+---+---+---+---+

(дополнительный экземпляр)                                      |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+         Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-|                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|малой|                |               +---------------+        +----------------+            |               |               |
|ско- |                |               | | | | | | | | |                         |            |               |               |
|рости|                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|     |                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+-----------------------------+---+---+-+-----------+-----+-------+------------+---------------------------+--------------------------+

|53 Сообщение                 |   |   | |60         |61   |62     |63          |68 Расчеты с отправителем  |69 Расчеты с получателем  |
|                             | | | | | |N позиции  |Класс|Ставка |Расчетная   +-------------+-------------+-------------+------------+

|                             +-+-+-+-+-+           |     |       |масса (кг)  |70 Сумма в   |71 Сумма в   |72 Сумма в   |73 Сумма в  |
|                                       |           |     |       |            |   .......   |   .......   |   .......   |   .......  |
+--+------------------------------------+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+------------+

|54|Провозная                           | | | | | | |  |  | | | | |            |74           |75           |76           |            |
+--+плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|-------------|-------------|            |
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+-------------+-------------+            |
|                   |  |  |=                                              +  > |78           |79           |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|55|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|56|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|57|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|58|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|59|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |77          |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|             |-------------|------------|
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+             +-------------+------------+

|                   |  |  |=                                              +  > |78           |             |80           |81          |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+------+-+-+-+-+-+---------+-+-+-+-+      |_____________|_____________|_____________|____________|
|90 Курс пересчета                                                      |      |_____________|_____________|_____________|____________|
+----------------------------------+------------------------------------+------+-------------+-------------+-------------+------------+

|   дороги отправления             |дороги назначения                   |Всего |86           |87           |88           |89          |
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
+----------------------------------+----+-------------------------------+------+-------------+-------------+-------------+------------+

|91 Отметки о расчетах платежей         |87 Всего взыскать с отправителя (прописью)                             Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |89 Всего взыскать с получателя (прописью)                              Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |92 Дополнительно взыскать с отправителя за                        ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
+---------------------------------------+---------------------------------------------------------------------------------------------+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

Дорожная ведомость                                              +--+--+--+---+---+---+---+---+

(дополнительный экземпляр)                                      |  |  |  |   |   |   |   |   |
+----+------------------------------------+---------------------+         Отправка N         +--------------------------------+

| РЖД|1 Отправитель, почтовый адрес       | | | | | | | | | | | |   (контрольная этикетка)   |2 Договор N                     |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                            +--------------------------------+

|    |                                                          +-----+----+----+----+---+---+                                |
|    |                                                          |3 Станция отправления                                        |
|    |                                                          |                                                             |
|    |                                                          +-------------------------------------------------------------+

|    +------------------------------------+---------------------+4 Особые заявления отправителя                               |
|    |5 Получатель, почтовый адрес        | | | | | | | | | | | |                                                             |
|    |                                    +-+-+-+-+-+-+-+-+-+-+-+                                                             |
|    |                                                          +-------------------------------------------------------------+

|    |                                                          |26 Отметки таможни                                           |
+----+----------------------------------------------------------+                                                             |
|6 Отметки, не обязательные для железной дороги                 |                                                             |
|                                                               +-------------------------------------------------------------+

+---------------------------------------------------------------+27 Вагон/28 Подъемная сила (т)                               |
|7 Пограничные станции перехода                                 |29 Оси/30 Масса тары                                         |
|                                                               |31 Масса груза после перегрузки                              |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |              27              |    28   |   29  |  30  |  31 |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|                                                               |                              |         |       |      |     |
+-----------------------------------------------+---+-----------+------------------------------+---------+-------+------+-----+

|8 Дорога и станция назначения                  |   |           |                              |         |       |      |     |
|                                               | | | | | | | | +------------------------------+---------+-------+------+-----+

|                                               +-+-+-+-+-+-+-+-+                              |         |       |      |     |
|                                                               +------------------------------+---------+-------+------+-----+

|      /                                                        |                              |         |       |      |     |
+-----+----------------+---------------+------------------------+----------------+------------++---------+----+--+------+-----+

|СМГС |9 Знаки, марки и|10 Род упаковки|11 Наименование груза   |50 Прил. 2  +-+ |12 Число    |13 Масса (в кг)|32 Масса (в кг)|
|- На-|  номера        |               |                        |            | | |   мест     |   определена  |   определена  |
|клад-|                |               |                        |            +-+ |            |   отправителем|   железной    |
|ная  |                |               |                        |                |            |               |   дорогой     |
|боль-|                |               +---------------+        +----------------+            |               |               |
|шой  |                |               | | | | | | | | |                         |            |               |               |
|ско- |                |               +-+-+-+-+-+-+-+-+                         |            |               |               |
|рости|                |               |                                         |            |               |               |
+-----+----------------+---------------+----------+------------------------------+------------+----+----------+---------------+

|14 Итого мест прописью                           |15 Итого масса прописью                         |16 Подпись отправителя    |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
|   ___________________________________________   |   __________________________________________   |                          |
+-------------------------------------------------+------------------------------------------------+--------------------------+

|17 Обменные поддоны .................            |Контейнер/Перевозочные средства                                            |
|                                        +-+-+-+-++---------------------------------------------+-----------------------------+

|                       +-------+        +-+-+-+-+|18 Вид                                       |19 Владелец и N              |
|   Количество .......  +-++-++-+ .....  +++++++++|   Категория                                 |                             |
|                       +-++-++-+         +-+ +-+ |                                             |                             |
+---------------------------------------------+---+-----------------------------------+---------+--------------+--------------+

|20 Отправителем приняты платежи за следующие |21 Род отправки                        |22 Погружено            |33            |
|   транзитные дороги                         +--------------+----------+-------------+------------+-----------+  |  |  |  |  |
|                                             |повагонная <*>|мелкая <*>|контейнерная |отправителем|железной   +--+--+--+--+--+

|                                             |              |          |<*>          |<*>         |дорогой    |34            |
|                                             |              |          |             |            |<*>        |  |  |  |  |  |
|                         +---+---+---+---+---+--------------+----------+-------------+------------+-----------+--+--+--+--+--+

|                         | | | | | | | | | | |<*> Ненужное зачеркнуть                                         |35            |
+-------------------------+-+-+-+-+-+-+-+-+-+-+----------------------------------------------------------------+  |  |  |  |  |
|23 Документы, приложенные отправителем       |24 Объявленная ценность груза              в                    +--+--+--+--+--+

|                                             |   _____________________________________                        |36            |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             |   _____________________________________                        |  |  |  |  |  |
|                                             +----------------------------------------------------------------+--+--+--+--+--+

|                                             |45 Пломбы                                                       |37            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |Количество|Знаки                                                +--+--+--+--+--+

|                                             |          |                                                     |38            |
|                                             +----------+-----------------------------------------------------+  |  |  |  |  |
|                                             |          |                                                     +--+--+--+--+--+

|                                             +----------+-----------------------------------------------------+39            |
|                                             |          |                                                     |  |  |  |  |  |
|                                             +----------+-----------------------------------------------------+--+--+--+--+--+

|                                             |          |                                                     |40            |
|                                             |          |                                                     |  |  |  |  |  |
+------------------------------+--------------+----------+----+-----------------------+------------------------+--+--+--+--+--+

|46 Календарный штемпель       |47 Календарный штемпель       |48 Способ определения  |49 Штемпель станции     |41            |
|   станции отправления        |   станции назначения         |   массы               |   взвешивания, подпись |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |42            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |43            |
|                              |                              |                       |                        |  |  |  |  |  |
|                              |                              |                       |                        +--+--+--+--+--+

|                              |                              |                       |                        |44            |
|                              |                              |                       |                        |  |  |  |  |  |
+------------------------------+------------------------------+-----------------------+------------------------+--+--+--+--+--+

+-----------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                             |
+-----------------------------------------------------------------------------------------------------------------------------+

+-------------------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                                     |
+-------------------------------------------------------------------------------------------------------------------------------------+

+-------------------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                                     |
+-------------------------------------------------------------------------------------------------------------------------------------+

+-----------------------------+---+---+-+-----------+-----+-------+------------+---------------------------+--------------------------+

|53 Сообщение                 |   |   | |60         |61   |62     |63          |68 Расчеты с отправителем  |69 Расчеты с получателем  |
|                             | | | | | |N позиции  |Класс|Ставка |Расчетная   +-------------+-------------+-------------+------------+

|                             +-+-+-+-+-+           |     |       |масса (кг)  |70 Сумма в   |71 Сумма в   |72 Сумма в   |73 Сумма в  |
|                                       |           |     |       |            |   .......   |   .......   |   .......   |   .......  |
+--+------------------------------------+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+------------+

|54|Провозная                           | | | | | | |  |  | | | | |            |74           |75           |76           |            |
+--+плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+-------------+-------------+            |
|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|-------------|-------------|            |
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+-------------+-------------+            |
|                   |  |  |=                                              +  > |78           |79           |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|55|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|56|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|57|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|58|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |            |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+            |
|   Дополнительные  |     |=                |  |  |=                      +    |-------------|             |-------------|            |
|   сборы           +--+--+-----------------+--+--+---------------------- >    +-------------+             +-------------+            |
|                   |  |  |=                                              +  > |78           |             |80           |            |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+--+---+-+-+-+-+-+---+-----+-+-+-+-+      |_____________|_____________|_____________|____________|
|59|                                    |60         |61   |62     |63   |      |_____________|_____________|_____________|____________|
+--+                                    |           |     |       |     +------+-------------+-------------+-------------+------------+

|   Провозная                           | | | | | | |  |  | | | | |            |74           |             |76           |77          |
|   плата от ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|         до ___________________________+-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|                                       | | | | | | |  |  | | | | |            |             |             |             |            |
|                   +-----+             +-+-+-+-+-+-+--+--+-+-+-+-+------------+-------------+             +-------------+------------+

|   Дополнительные  |  |  |=                |  |  |=                      +    |             |             |             |            |
|   сборы           +--+--+-----------------+--+--+---------------------- |    |-------------|             |-------------|------------|
|                   |  |  |=                |  |  |=                      >    |             |             |             |            |
|                   +--+--+-----------------+--+--+---------------------- |    +-------------+             +-------------+------------+

|                   |  |  |=                                              +  > |78           |             |80           |81          |
+--+----------------+--+--+----------+------+---------+---------+-------+------+-------------+-------------+-------------+------------+

|64|                |65|             |66    |         |67 Тариф |       |Итого |82           |83           |84           |85          |
|  |  |  |  | | | | |  | | | | | | | |км    | | | | | |         | | | | |      |_____________|_____________|_____________|____________|
+--+--+--+--+-+-+-+-+--+-+-+-+-+-+-+-+------+-+-+-+-+-+---------+-+-+-+-+      |_____________|_____________|_____________|____________|
|90 Курс пересчета                                                      |      |_____________|_____________|_____________|____________|
+----------------------------------+------------------------------------+------+-------------+-------------+-------------+------------+

|   дороги отправления             |дороги назначения                   |Всего |86           |87           |88           |89          |
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
|                                  |                                    |      |_____________|_____________|_____________|____________|
+----------------------------------+----+-------------------------------+------+-------------+-------------+-------------+------------+

|91 Отметки о расчетах платежей         |87 Всего взыскать с отправителя (прописью)                             Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |89 Всего взыскать с получателя (прописью)                              Подпись               |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       |   ____________________________________________________________                              |
|                                       +---------------------------------------------------------------------------------------------+

|                                       |92 Дополнительно взыскать с отправителя за                        ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
|                                       |                                                                  ___________________________|
+---------------------------------------+---------------------------------------------------------------------------------------------+

+-------------------------------------------------------------------------------------------------------------------------------------+

|                                                                                                                                     |
+-------------------------------------------------------------------------------------------------------------------------------------+

Письмо Минтранса РФ от 24 мая 2010 г. N ОБ-16/5460 О формах транспортных (товаросопроводительных) документов, которые могут использоваться при перемещении товаров в Таможенном союзе