Customs Clearance Waiver Form

Customs Clearance Waiver Form
Please complete this form to authorize customs clearance on your behalf.
Full Name
First NameLast Name
Company Name
Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Description of Goods
Reason for Waiver
Signature
Clear
Date
MonthDayYear
Date
Should be Empty: