Microsoft word - mkc poa instructions only 100509.doc
INSTRUCTIONS TO COMPLETE CUSTOMS POWER OF ATTORNEY FORM For each of the Circled Numbers appearing on the Customs Power of Attorney Form, please follow the instructions listed below. c Print/Type Your Company’s Federal Employer Identification Number.
For Partnership, Corporation and Limited Liability Company entities Insert Your Company’s Federal
Employer Identification Number (IRS Number/Tax I.D. Number). Example: 12-3456789XX
If an Individual or Sole Proprietorship, Insert Your Social Security Number. Example: 123-45-6789
Check Box for Type of Business that Describes Your Company. Print/Type Your Company’s Full Legal Name.
The name must be complete; abbreviations should not be used.
For individual and sole proprietorship entities use full legal name without initials or abbreviations.
Print/Type Your Company’s Type of Business. Example Identify: Individual, Partnership (General or Limited), Sole Proprietorship, Corporation or
g Print/Type the Name of the State in which the Principal Received Authority to Conduct Business.
[If not in the USA; the following statement is sufficient to establish the authority of the grantor (person signing the POA on
behalf of the foreign entity if placed on the letterhead of the company)].
“I (individual’s name) certify that I am the (title/position) of (company name), organized under the laws of (state/country) and that (Authorized Company Officer) who signed this Power of Attorney on behalf of the donor is the (title/position of Authorized Company Officer) of said company, and that said Power of Attorney was duly signed & attested for and on behalf of said company by authority of its governing body, as the same appears in a resolution of said governing body passed at a regular meeting held on (date of resolution) now in my possession or custody. I further certify that this Power of Attorney was executed in accordance with all applicable laws of said country.” (Followed by: signature, printed name, title, company name, and date)”
Print/Type Your Company’s Address. (P.O. Box Addresses cannot be accepted.)
Corporation or LLC (Limited Liability Company) – Use your business address
Individual or Sole Proprietor – Use your residence and business address
Partnership – Use your business address and include the below information for type of partnership.
General Partnership – On a separate page list the individuals full name (no abbreviation) and
resident address of all general partners.
Limited Partnership – On a separate page list the general partners full name (no abbreviation) and
resident address for all limited partners.
INSTRUCTIONS TO COMPLETE CUSTOMS POWER OF ATTORNEY FORM -- Continued -- Print/Type the Full Legal Name of Company. (Same as e above) Print/Type Month/Day/Year that the Power of Attorney is Signed.
Note: If the Power of Attorney is for a Partnership, it will expire 2 years from the date the
Written Signature of Person Executing the Power of Attorney. On “Print Name Line”, Type or Print the Name of the Person Signing the Form. On “Print Title/Position Line”, Type or Print the Full Title/Position of the Person Signing the Form.
Authorized Signatures to Power of Attorney:
If Company is a Corporation, only the President, Vice President, Secretary, or Treasure of the Corporation may sign the form,
unless the Signor for the Corporation has been Granted Expressed Authority to Sign by Resolution of the Board of Directors
and by Power of Attorney form the Corporation to sign on its behalf. Submit Copy of Corporate Power of Attorney to Signor if
Signor is not an Officer of the Corporation.
If Company is a Limited Liability Company (LLC), the Form must be signed by a Manager or Member of the LLC.
If the Entity is an Individual or Sole Proprietorship, the Form must be signed by the Owner.
Written Signature of Person who is the Witness to the Authorized Signature for k above. On “Print Title/Position Line”, Type or Print the Full Title/Position of the Person Signing as the Witness. Only supply Signature if required by Principal. INSTRUCTIONS TO COMPLETE “PAGE 2” OF CUSTOMS POWER OF ATTORNEY FORM Please follow the instructions listed below to complete the “Certification Statements” on Page 2 of the Power of Attorney Form.
c Type/Print Your Company’s Federal Employer Identification Number.
For Partnership, Corporation and Limited Liability Company entities Insert Your Company’s Federal Employer
Identification Number (IRS Number/Tax I.D. Number). Example: 12-3456789XX
If an Individual or Sole Proprietorship, Insert Your Social Security Number. Example: 123-45-6789
Type/Print Your Company’s Full Legal Name.
The name must be complete; abbreviations should not be used.
For individual and sole proprietorship entities insert full name without initials or abbreviations.
For USA Residents: “Individual, Partnership, Sole Proprietorship Certification” needs Only to be Completed and Certified by
a Notary Public if the Individual or Sole Proprietor is unable to furnish MCK Customs Brokers International, Inc.
with a Copy of the Individual’s or Sole Proprietor’s Social Security Card or Copy of a Letter from the Internal
Revenue Service showing the Tax Identification Number corresponding to the Individual or Sole Proprietor.
“Individual, Partnership, Sole Proprietorship Certification” is no longer required by the Customs
regulations for Partnerships. Do Not Complete.
For Non-USA Residents: “Individual, Partnership, Sole Proprietorship Certification” is required for the Individual, Sole Proprietor
or Partnership in all cases. The Certification is to be completed by a Foreign Public Officer in the Foreign
For USA Corporations and Limited Liability Companies:
The “Corporate Certification” is no longer required by the Customs Regulations to be completed. For Foreign Corporations and Limited Liability Companies:
The “Corporate Certification” is required for all foreign Corporations and Limited Liability Companies in all
cases. The Corporate Certification requires its completion by an Officer of the Corporation or the Limited Liability
Company, other than the officer who executes the Power of Attorney.
Olive Lifesciences Pvt. LtdNo. 2203, Pragathi,16th Cross, 8th Main, D BlockShakara Nagar, Bangalore 560092IndiaThis is to certify that the 65 products specified in the product listing below, manufacturedby OLIVE LIFESCIENCES PVT. LTD of the above address, are Kosher and under oursupervision. PLEASE NOTE THE FOLLOWING CONDITIONS OF CERTIFICATION: All products listed below are Pareve. A
INTERNATIONAL MARITIME ORGANIZATION 4 ALBERT EMBANKMENT E LIST OF CONTENTS OF THE “EMERGENCY MEDICAL KIT/BAG” AND MEDICAL CONSIDERATION FOR ITS USE ON RO-RO PASSENGER SHIPS NOT NORMALLY CARRYING A MEDICAL DOCTOR The Maritime Safety Committee (MSC), at its seventy-fifth session, 15 to 24 May 2002, recalled that, in paragraph 1.3.3 of chapter 1 of the Annex to the Intern