Business Entity Multi-Country Customs Authorization
1. Business Entity Information
Entity Name
Registered Address
Country of Incorporation
Registration Number
Contact Person
Email Address
Phone Number
2. Authorized Representative(s)
Name
Position/Title
Country/Region
Identification Document
3. Authorization Scope
Countries/Regions Covered
Description of Customs Activities Authorized
Authorization Validity (From - To)
4. Declarations & Agreement
Authorized Signature
Name:
Date:
Company Stamp / Seal