DEPARTMENT OF HOMELAND SECURITY U.S. ??DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection ... CBP Form 5291 (09/08) CITY COUNTY STATE On

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  • , or until notice of revocation in writing is duly given toand received by the Port Director of CBP of the portaforesaid. If the donor of this power of attorney is apartnership, the said power shall in no case have any forceor effect after the expiration of 2 years from the date of itsreceipt in the office of the Port Director of CBP of the saidport.

    DEPARTMENT OF HOMELAND SECURITYU.S. Customs and Border Protection

    POWER OF ATTORNEY19 CFR 141.32

    Check appropriate box: Individual Corporation Sole Proprietorship

    KNOW ALL MEN BY THESE PRESENTS:That

    (Full Name of person, partnership, or corporation, or sole proprietorship; identify)

    a corporation doing business under the laws of the State of or a

    doing business as residing at

    , hereby constitutes and appoints each of the following persons

    (Give full name of each agent designated)

    as a true and lawful agent and attorney of the grantornamed above for and in the name, place, and stead of saidgrantor from the date and in CBP Port

    To make endorsements on bills of lading conferringauthority to make entry and collect drawback, and to make,sign, declare, or swear to any statement, supplementalstatement, schedule, supplemental schedule, certificate ofdelivery, certificate of manufacture, certificate ofmanufacture and delivery, abstract of manufacturingrecords, declaration of proprietor on drawback entry,declaration of exporter on drawback entry, or any otheraffidavit or document which may be required by law orregulation for drawback purposes, regardless of whethersuch bill of lading, sworn statements, schedule, certificate,abstract declaration, or other affidavit or document isintended for filing in said port or in any other CBP port;

    To sign, seal, and deliver for and as the act of saidgrantor any bond required by law or regulation inconnection with the entry or withdrawal of importedmerchandise or merchandise exported with or withoutbenefit of drawback, or in connection with the entry,

    clearance, lading, unlading or navigation of any vessel orother means of voluntarily given and accepted underapplicable laws and regulations, consignee's and owner'sdeclarations provided for in section 485, Tariff Act of 1930,as amended, or affidavits in connection with the entry ofmerchandise.

    To sign and swear to any document and to perform anyact that may be necessary or required by law or regulationin connection with the entering, clearing, lading, unlading,or operation of any vessel or other means of conveyanceowned or operated by said grantor;

    And generally to transact at the CBP houses in said portany and all CBP business, including making, signing, andfiling of protests under section 514 of the Tariff Act of 1930,in which said grantor is or may be concerned or interestedand which may properly be transacted or performed by anagent or attorney, giving to said agent and attorney fullpower and authority to do anything whatever requisite andnecessary to be done in the premises as fully as saidgrantor could do if present and acting, hereby ratifying andconfirming all that the said agent and attorney shall lawfullydo virtue of these presents; the foregoing power of attorneyto remain in full force and effect until the

    IN WITNESS WHEREOF, the said

    (Corporate Seal) * (Optional) CBP Form 5291 (09/08)

    Partnership

    Has caused these presents to be sealed and signed: (Signature)

    (Date)(Capacity)

    WITNESS:

    other name, top make endorse, sign declare, or swear toany entry, withdrawal, declaration, certificate, bill of lading,or other document required by law or regulation inconnection with the importation, transportation, orexportation of any merchandise shipped or consigned by orto said grantor; to perform any act or condition which maybe required by law or regulation in connection with suchmerchandise; to receive any merchandise deliverable tosaid grantor;

    and in no

    day of20

  • INDIVIDUAL OR PARTNERSHIP CERTIFICATION * (Optional)

    } ss:

    (Notary Public)

    CORPORATE CERTIFICATION * (Optional)

    (To be made by an officer other than the one who executes the power of attorney)

    CBP Form 5291 (09/08)

    CITY

    COUNTY

    STATE

    On this day of , 20 , personally appeared before meresiding at

    , personally known or sufficiently identified to me, who certifies

    that (is)(are) the individual(s) who executed the

    foregoing instrument and acknowledged it to be free act and deed.

    I, , certify that I am the

    of

    organized under the laws of the State of that , who

    signed this power of attorney on behalf of the donor, is the of said

    corporation; and that said power of attorney was duly signed, sealed, and attested for and on behalf of said corporation by

    authority of its governing body as the same appears in a resolution of the Board of Directors passed at a regular meeting

    held on the day of , now in my possession or custody. I further certify that the

    resolution is in accordance with the articles of incorporation and bylaws of said corporation.

    IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said corporation, at the City of

    day ofthis , 20

    (Signature) (Date)

    If the corporation has no corporate seal, the fact shall be stated, in which case a scroll or adhesive shall appear in the appropriate,designated place.U.S. Customs and Border Protection powers of attorney of residents (including resident corporations) shall be without power ofsubstitution except for the purpose of executing shipper's export declaration. However, a power of attorney executed in a favor of alicensed customhouse broker may specify that he power of attorney is granted to the customhouse broker to act through any of itslicensed officers or any employee specifically authorized to act for such customhouse broker by power of attorney.NOTE: The corporate seal may be omitted. CBP does not require completion of a certification. The grantor has the option of executingthe certification or omitting it.

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    , or until notice of revocation in writing is duly given to and received by the Port Director of CBP of the port aforesaid. If the donor of this power of attorney is a partnership, the said power shall in no case have any force or effect after the expiration of 2 years from the date of its receipt in the office of the Port Director of CBP of the said port.

    DEPARTMENT OF HOMELAND SECURITYU.S. Customs and Border Protection

    POWER OF ATTORNEY

    19 CFR 141.32

    Check appropriate box:

    Individual

    Corporation

    Sole Proprietorship

    KNOW ALL MEN BY THESE PRESENTS:

    That

    (Full Name of person, partnership, or corporation, or sole proprietorship; identify)

    a corporation doing business under the laws of the State of

    or a

    doing business as

    residing at

    , hereby constitutes and appoints each of the following persons

    (Give full name of each agent designated)

    as a true and lawful agent and attorney of the grantornamed above for and in the name, place, and stead of saidgrantor from the date and in CBP Port

    To make endorsements on bills of lading conferringauthority to make entry and collect drawback, and to make,sign, declare, or swear to any statement, supplementalstatement, schedule, supplemental schedule, certificate ofdelivery, certificate of manufacture, certificate of manufacture and delivery, abstract of manufacturingrecords, declaration of proprietor on drawback entry,declaration of exporter on drawback entry, or any other affidavit or document which may be required by law orregulation for drawback purposes, regardless of whethersuch bill of lading, sworn statements, schedule, certificate,abstract declaration, or other affidavit or document isintended for filing in said port or in any other CBP port;

    To sign, seal, and deliver for and as the act of saidgrantor any bond required by law or regulation inconnection with the entry or withdrawal of imported merchandise or merchandise exported with or withoutbenefit of drawback, or in connection with the entry,

    clearance, lading, unlading or navigation of any vessel or other means of voluntarily given and accepted under applicable laws and regulations, consignee's and owner's declarations provided for in section 485, Tariff Act of 1930, as amended, or affidavits in connection with the entry of merchandise.

    To sign and swear to any document and to perform any act that may be necessary or required by law or regulationin connection with the entering, clearing, lading, unlading,or operation of any vessel or other means of conveyance owned or operated by said grantor;

    And generally to transact at the CBP houses in said port any and all CBP business, including making, signing, and filing of protests under section 514 of the Tariff Act of 1930, in which said grantor is or may be concerned or interested and which may properly be transacted or performed by an agent or 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 virtue of these presents; the foregoing power of attorney to remain in full force and effect until the

    IN WITNESS WHEREOF, the said

    (Corporate Seal) * (Optional)

    CBP Form 5291 (09/08)

    Partnership

    Has caused these presents to be sealed and signed:(Signature)

    (Date)

    (Capacity)

    WITNESS:

    other name, top make endorse, sign declare, or swear toany entry, withdrawal, declaration, certificate, bill of lading,or other document required by law or regulation inconnection with the importation, transportation, orexportation of any merchandise shipped or consigned by or to said grantor; to perform any act or condition which may be required by law or regulation in connection with suchmerchandise; to receive any merchandise deliverable tosaid grantor;

    and in no

    day of

    20

    INDIVIDUAL OR PARTNERSHIP CERTIFICATION *(Optional)

    }

    ss:

    (Notary Public)

    CORPORATE CERTIFICATION *

    (Optional)

    (To be made by an officer other than the one who executes the power of attorney)

    CBP Form 5291 (09/08)

    CITY

    COUNTY

    STATE

    On this

    day of

    , 20

    , personally appeared before me

    residing at

    , personally known or sufficiently identified to me, who certifies

    that

    (is)(are) the individual(s) who executed the

    foregoing instrument and acknowledged it to be

    free act and deed.

    I,

    , certify that I am the

    of

    organized under the laws of the State of

    that

    , who

    signed this power of attorney on behalf of the donor, is the

    of said

    corporation; and that said power of attorney was duly signed, sealed, and attested for and on behalf of said corporation by

    authority of its governing body as the same appears in a resolution of the Board of Directors passed at a regular meeting

    held on the

    day of

    , now in my possession or custody. I further certify that the

    resolution is in accordance with the articles of incorporation and bylaws of said corporation.

    IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said corporation, at the City of

    day of

    this

    , 20

    (Signature)

    (Date)

    If the corporation has no corporate seal, the fact shall be stated, in which case a scroll or adhesive shall appear in the appropriate, designated place.

    U.S. Customs and Border Protection powers of attorney of residents (including resident corporations) shall be without power of substitution except for the purpose of executing shipper's export declaration. However, a power of attorney executed in a favor of a licensed customhouse broker may specify that he power of attorney is granted to the customhouse broker to act through any of its licensed officers or any employee specifically authorized to act for such customhouse broker by power of attorney.

    NOTE: The corporate seal may be omitted. CBP does not require completion of a certification. The grantor has the option of executing the certification or omitting it.

    Individual: 0Partnership: 0Corporation: 0Sole Proprietorship: 0Full Name of person, partnership, or corporation, or sole proprietorship; identify: State: or a: doing business as: place of residence Line 1 of 2: place of residence Line 2 of 2: Give full name of each agent designated : C B P Port: Last 2 digits of 4 digit year: Day: IN WITNESS WHEREOF, the said: Signature. This is a protected field.: Capacity: Date. Enter 2 digit month, 2 digit day and 4 digit year.: Witness. Line 1 of 2.: Witness. Line 2 of 2.: City: County: State: Day: Month: Last 2 digits of 4 digit year: Name: Residing at. Line 1 on 2.: Residing at. Line 2 on 2.: Name: Notary Public: Name: certify that I am the: Of: State: who signed this power of attorney: Is the: Month: City of: Day : Month: Last 2 digits of 4 digit year: Signature. This is a protected field.: Date. Enter 2 digit month, 2 digit day and 4 digit year.:

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