CUSTOMS POWER OF ATTORNEYForPERSONAL EFFECTS/HOUSEHOLD GOODSKNOW ALL MEN BY THESE PRESENTS: That,_______________ ____
(Full Name of individual transferring to the United States-Owner of Personal Effects)

Passport and/ or U.S. Social Security No.

______________________________________________________

Having a place of residence or U.S. address at:_____________, hereby constitutes and appoints_________________________________________ its officers, employees, and/or specifically authorized agents, to act for and on its behalf as a trueand lawful agent and attorney of the grantor for and in the name, place and stead of said grantor, from this date, in the United States (the territory) either
in writing, electronically, or by other authorized means to:Make, endorse, sign, declare, or swear to any customs entry, withdrawal, declaration, certificate, bill of lading, carnet or any other documents required bylaw or regulation in connection with the importation, exportation, transportation, of any merchandise in or through the customs territory, shipped orconsigned by or to said grantor;
Perform any act or condition which may be required by law or regulation in connection with such merchandise deliverable to said grantor; to receive any
merchandise;
Make endorsements on bills of lading conferring authority to transfer title; make entry or collect drawback; and to make, sign, declare, or swear to any
statement or certificate required by law or regulation for drawback purposes, regardless of whether such document is intended for filing with Customs
and Border Protection;
Sign, seal, and deliver for and as the act of said grantor any bond required by law or regulation in connection with the entry or withdrawal of imported
merchandise or merchandise exported with or without benefit of drawback, or in connection with the entry, clearance, lading, unlading or navigation ofany vessel or other means of conveyance owned or operated by said grantor, and any and all bonds which may be voluntarily given and accepted underapplicable laws and regulations, consignee’s and owner’s declarations provided for in section 485, Tariff Act of 1930, as amended, or affidavits orstatements in connection with the entry of merchandise;
Sign and swear to any document and to perform any act that may be necessary or required by law or regulation in connection with entering, clearing,lading, unlading, or operation of any vessel or other means of conveyance owned or operated by said grantor;
Authorize other Customs Brokers duly licensed within the territory to act as grantor’s agent; to receive endorse and collect checks issued for Customs
and Border Protection duty refunds in grantor’s name drawn on the Treasurer of the United States; if the grantor is a nonresident of the United States, toaccept service of process on behalf of the grantor;
And generally to transact Customs business, including filing of claims or protests under section 514 of the Tariff Act of 1930, or pursuant to other laws of
the territories, in which said grantor is or may be concerned or interested and which may properly be transacted or performed by an agent and attorney;
Giving to said agent and attorney full power and authority to do anything whatever requisite and necessary to be done in the premises as fully as said
grantor could do if present and acting, hereby ratifying and confirming all that the said agent and attorney shall lawfully do by virtue of these presents;
This power of attorney to remain in full force and effect until revocation in writing is duly given to and received by grantee (if the donor of the power ofattorney is a partnership, the said power shall in no case have any force or effect in the United States after the expiration of two years from the date of its
execution);Appointment as Forwarding Agent: Grantor authorizes the above grantee to act within the territory as lawful agent to sign or endorse export documents(i.e., commercial invoices, bills of lading, insurance certificates, drafts and any other document) necessary for the completion of an export on grantor’sbehalf as may be required under law and regulation in the territory and to appoint forwarding agents on grantor’s behalf;
Grantor hereby acknowledges receipt of ______________________________terms and conditions of service governing all transactions between parties.
If the Grantor is a Limited Liability Company, the signatory certifies that he/she has full authority to execute the power on behalf of the Grantor.
IN WITNESS WHEREOF, the said_______________(Full Name of individual transferring to the United States-Owner of Personal Effects)

Caused these presents to be sealed and signed: (Signature)(Capacity)

INDIVIDUAL BEING TRANSFERED TO U.S./OWNER OF PERSONAL EFFECTS

Witness: (if required)________________
Date:

__

_________________

Name: __________________________________________________ Address: _________________________________________________________
If you are the importer of record, payment to the broker will not relieve you of liability for U.S. Customs and Border Protection charges (duties, taxes or other debts owed Customs) in the event the charges
are not paid by the broker. Therefore, if you pay by check, U.S. Customs and Border Protection charges may be paid with a separate check payable to “U.S. Customs and Border Protection” which shallbe delivered to Customs by the broker. Importers who wish to utilize this procedure must contact our office in advance to arrange timely receipt of duty checks.