Importer Letter of Authorization

Importer Letter of Authorization
Authorize a third party to act on your behalf for import-related activities.
Importer Company Name
Importer Company Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Importer Contact Person (Full Name)
First NameLast Name
Importer Contact Email
example@example.com
Importer Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Party Name (e.g., Customs Broker or Agent)
Authorized Party Company (if applicable)
Description of Goods or Shipment
Purpose and Scope of Authorization (e.g., customs clearance, shipment handling)
Reference Number or Shipment Number (if applicable)
Authorization Effective Date
MonthDayYear
Date
Authorization Expiry Date (if applicable)
MonthDayYear
Date
Signature of Importer or Authorized Representative
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