Current LVI Form

Thank you for taking the time to update/provide GHY/Breeze Customs with your company information. Please provide the information requested in the fields below and submit.
Customs Contact
Import Destination*

CanadaUnited StatesBoth Countries
Importer Type*
Will this be a one-time import?*
How many shipments do you expect in the next 12 months?*
Please enter an approximate amount.
Your Name*

First Name Last Name
Your Title*
Your Phone*
Please enter a valid phone number.
Your Email*
example@example.com
Legal Company Name*
Legal Name of Importer*
Select Entity Type
Do you have a Canadian Business Number?*
Canadian Business (Importer) Number*
no problem, we will send you a business number (importer) application as part of the setup documents
US Tax ID (Importer Number)*
Importer Physical Address
Importer Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
State/Province of Incorporation of Company*
State/Province of Incorporation/Registration
Importer Mailing Address
Importer Mailing Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Importer Tax and Goods Info
What are you importing?*
What is the value (for duty) of your goods?*
Signing Officer
Name*

First Name Last Name
Title*
Title*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Second Signing Officer
Name*

First Name Last Name
Title*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Billing Contact
Name*

First Name Last Name
Title*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Should be Empty:

Customs Contact

Importer Physical Address

Importer Mailing Address

Importer Tax and Goods Info

Signing Officer

Second Signing Officer

Billing Contact