WRITTEN AUTHORIZATION
TO PREPARE OR TRANSMIT SHIPPER’S INFORMATION *EIN/IRS
NO:_____________________________________________________________________
*If EIN/IRS No. is not available, use Social Security Number (SSN),
If neither are available, use border crossing number, passport
number or Customs Identification Number I,
_____________________________________________________________________________,
at
(Exporter (U.S. Principal Party of Interest __________________________________________________________________________________________
authorize
(Address) MHX INTERNATIONAL
LLC, to act as forwarding agent for the export control
and customs
(Forwarding Agent) purposes and to sign any Shipper’s
Export Declaration (SED), or transmit such export information
electronically, which may be required by law or regulation in
connection with the exportation or transportation of any
merchandise on behalf of said U.S. Principal Party in
Interest. The U.S. Principal Party in
Interest certifies that necessary and proper documentation to
accurately complete the SED or transmit the information
electronically is and will be provided to the said Forwarding
Agent. The U.S. Principal Party in
Interest understands that civil and criminal penalties may be
imposed for making false or fraudulent statements or for the
violation of any United States laws or regulations on exportation
and agrees to be bound by all statements of said agent based upon
information or documentation provided by exporter to said
agent. ___________________________________________
Signature (U.S. Principal party in Interest) ___________________________________________
Name (U.S. Principal party in Interest) ___________________________________________
Capacity ___________________________________________
Date | 
