INTERMOUNTAIN FORWARDING COMPANY
Telephone: (208) 887-9440
Fax: (208) 887-1792
673 W. Christopher St.
Meridian, ID 83642
U.S. Customs require that written authorization to prepare or transmit shipper's export information
by an International Freight Forwarder be completed by shipper
and faxed or mailed to the Freight Forwarder.
If you are a first time Exporter with our company,
please copy this form on your letterhead and fax or mail it directly to our office listed above.
I, ________________________________________, a duly authorized Officer or Employee of
(company name) ________________________________________________, a
____Corporation, ____Partnership, ____Proprietorship or ____Individual
located (address) ___________________________________________________
City _______________, State of _________________,Zip Code ___________
Telephone: ________________________Fax: _________________
IRS / EIN # _________________________________ or
Social Security # ______________________
authorize INTERMOUNTAIN FORWARDING COMPANY, 673 W. Christopher St, Meridian, ID 83642 to act as forwarding agent for export control and customs purposes and to sign any Shipper's Export Declaration (SED), or transmit such export information electronically, which may be required by law or regulation in connection with the exportation or transportation of any merchandise on behalf of said U.S. Principal Party in Interest. The U.S. Principal Party in Interest certifies that necessary and proper documentation to accurately complete the SED or transmit the information electronically is and will be provided to the said Forwarding Agent. The U.S. Principal Party in Interest further understands that civil and criminal penalties may be imposed for making false or fraudulent statements or for the violation of any United States laws or regulations on exportation and agrees to be bound by all statements of said agent based upon information or documentation provided by exporter to said agent.
Signature: _____________________________________________
(U.S.Principal Party in Interest/Exporter)
Capacity: _____________________,Date: ______________
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