The fillable PDF is the document JFS CHB executes: two pages, the power of attorney and the terms it refers to. Download it, type into it, print and sign. This page is for working out what goes in the boxes before you do — it carries the same grant language, and it is not a substitute for the form.
This runs entirely in your browser. Nothing here is submitted, emailed or saved — when you are finished, print it or send us the signed copy yourself.
The form itself. Download the fillable PDF — it opens in any PDF reader and the fields are typeable. That is the document to sign and send to sales@jfschb.com.
This is a legal document. Do not use white out to make corrections.
Entity Type: LLC
IRS Number (EIN):
KNOW ALL MEN BY THESE PRESENTS: That, , doing business as , under the laws of the State of , residing or having an office and place of business at ,
hereby designates and appoints, JFS CHB, Inc., its heirs and assigns, and its licensed officers and employees, specifically authorized to act for said corporation by power of attorney as a true and lawful agent and attorney of the grantor for and in the name, place and stead of said grantor, from this date, in all Customs Districts, and in no other name, to make, endorse, sign, declare, or swear to any entry, withdrawal, declaration, certificate, bill of lading, carnet or any other documents required by law or regulation in connection with the importation, exportation, transportation, 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 such merchandise; to receive any merchandise deliverable to said grantor;
To act as forwarding agent for the purpose of export control and export clearance for grantor. Grantor hereby certifies that the information provided for the purposes of export control and export clearance is complete and accurate;
To make endorsements on bills of lading conferring authority to transfer title; make entry or collect drawback; and to make, sign, declare, or swear to any statement, supplemental statement, schedule, supplemental schedule, certificate of delivery, certificate of manufacture, certificate, certificate of manufacture and delivery, abstract of manufacture records, declaration of proprietor on drawback entry, declaration of exporter on drawback entry, or any other affidavit or document which may be required by law or regulation for drawback purposes, regardless of whether such bill of lading, sworn statement, schedule, certificate, abstract, declaration, or other affidavit or document is intended for filing in any customs district;
To sign, seal, and deliver for and as the act of said grantor any bond required by law or regulation in connection with the entry or withdrawal of imported merchandise or merchandise exported with or without benefit of drawback, or in connection with the entry, clearance, lading, unlading or navigation of any vessel or other means of conveyance owned or operated by said grantor, and any and all bonds which may be 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 or statements 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 regulation in connection with the entering, clearing, lading, unlading, or operation of any vessel or other means of conveyance owned or operated by said grantor;
To authorize other Customs Brokers to act as grantor's agent; to receive, endorse and collect checks issued for Customs duty refunds in grantor's name drawn on the Treasurer of the United States; if the grantor is a nonresident of the United States, to accept service of process on behalf of the grantor;
To share and release records referred to in 19 C.F.R., Parts 111 and 163, including any documents, data, or information pertaining to the business of the grantor, with any subsidiaries, divisions and/or specifically authorized agents of JFS CHB Inc.
And generally to transact at the customshouses in any district any customs business, including making, signing and filing of protests under section 514 of the Tariff Act of 1930, in which grantor is or may be concerned or interested and which may properly be transacted or performed by an agent and 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 by virtue of these presents;
the foregoing power of attorney to remain full force and effect until Until Revoked or until notice of revocation in writing is duly given to and received by a District Director of Customs. 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 two (2) years from the dates of its execution.
JFS CHB Inc. agrees to provide Customer (identified above) with transportation, customs brokerage and other services subject to JFS CHB Inc. Terms and Conditions of Service, which the Customer acknowledges receipt of. Customer agrees to pay JFS CHB Inc. for these services and any monies advanced, in accordance with JFS CHB Inc.'s normal payment terms, and accepts and agrees to comply with these Terms and Conditions of Service.
Those terms are page 2 of the PDF. They are not reproduced here — read them at jfschb.com/terms before signing anything.
In the execution of this document, it is expressly understood that payment to the grantee, if a broker, does not relieve the Grantor of liability for Customs charges (duties, taxes, or other debts owed Customs) in the event the charges are not paid by the broker. Therefore, if payment is by check, Customs charges may be paid with a separate check payable to "U.S. Customs & Border Protection" which shall be delivered to Customs by the broker. Pursuant to 19 C.F.R. 111.36(c)(2)(i), Grantor waives the requirement for JFS CHB Inc. to transmit directly to the importer a true copy of the brokerage charges if the fees and charges are to be collected by or through a forwarder.
V. 3 Dec 2024 · rendered from template 2026-08-09.1. Four typographical errors in the printed form are corrected in this rendering — “any and all bonds”, “separate check”, “filing” and “through a forwarder”. The wording is otherwise the form's own, and the PDF remains the governing document.
