Customs Clearance Direct Representative Form.

Appointment of a Customs Clearance Agent to act as a Direct Representative
I, (enter first name and last name in the form fields)

First NameLast Name
Having authority to sign on behalf of: (Insert name)
(EORI No.)
Hereby appoint:

Ace Express Freight
Blakes Cross
Lusk
Co Dublin K45 WY42 Ireland
EORI number: IE 4883577V
CAE 44360
B Ascot Freight Ltd T/A Ace Express Freight (EORI no.) IE 4883577V (iii)

to act on behalf of the entity named at A above in the capacity of a Direct Representative in accordance with Article 18 and 19 of Regulation (EU) 952/2013 of the European Parliament and the Council of 9 October 2013 (The Union Customs Code).

This Appointment applies with effect from the date of signature until revoked by the entity named at A above.

Note: In accordance with the Union Customs Code, a Direct Representative acts in the name of and on behalf of another person. In relation to import/export declarations, the importer/exporter will be liable for any customs debt arising from the declaration.
Signed:
Position
Dated

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Notes:

(i) Name of person signing, who must have authority to sign on behalf of the importer or exporter.
(ii) Legal name & EORI No. of importer or exporter.
(iii) Legal name & EORI No. of representative or agent.
Ace Express Freight Blakes Cross, Lusk, Co Dublin sales@ace-express.com Registered: Dublin, Ireland. Registered No: 137472. VAT No: IE 4883577V. Directors: P. Tracey, M. Tracey, J. Tracey.
Should be Empty: