YOUR ADDRESS EMAIL , (place) Hereby we appoint and authorize Customs Agency PMST Transmeble International Sp. z o.o.(Ltd), 60-771 Poznań, ul. Konopnickiej 19/2, Regon 630225139, VAT(NIP) PL7821000022 General Customs Office Permission No. 577, to be our agent in indirect form, and take on the name and behalf of: (name and address of authorizing company) the following actions involved to trade turnover between Poland and abroad: a) inspection of goods and collecting samples before customs formalities, b) preparing and issuing documents necessary for customs clearance, c) paying all customs import/export and other charges, d) picking up cleared goods, e) deposing assets guarantee for customs debts, f) appealing and deposing the applications for customs clearance formalities to Customs Office. At the same time we agree to further authorization according to Art.77 Customs Law (Dz.U.No.7, 20.04.2004, pos.622). The authorization is general and* : − without time limitation or − valid until − given once (signature and stamp of authorizing person) (customs agent signature, date) *cancel useless
