Company Name

Contact Name

Position in Company

Contact Telephone Number

Contact Email Address

Accounts Telephone number (if different from above).

Accounts Email Address

VAT Registered in UK VAT Registered in UKYesNo

VAT Number

If VAT reg., are you using the HMRC postponed VAT accounting (PVA) scheme? If VAT reg., are you using the HMRC postponed VAT accounting (PVA) scheme?YesNo

EORI Number (commercial shipments only)

AEO Accreditation Number (If you have one)

Type Of Company (Limited, Partnership, Sole Trader etc.)

HMRC Deferment Account no. (If you have one)

Date Began Trading

Nature Of The Business (e.g Retailer, Wholesaler, Internet Seller, Manufacturer, Charity, Service Provider etc)

Company Reg Number (If Appl)

Directors - If your company has been trading for less than 3 years, please list the name and nationality of all the company directors

Building Number

Road Name

Address Line 2

City / Town

County / State

Postcode / Zip Code

Country

Deferment Approval Number: (if no Deferment number, then leave blank)

Company VAT Number: (if not VAT registered, then leave blank)

Direct Representation Declaration (please tick to confirm you have read and understood): Direct Representation Declaration (please tick to confirm you have read and understood): I hereby authorise UK Import Services Limited [EORI GB970594195000] to act on behalf of the importer named below, in the capacity of direct Customs agent in accordance with Schedule 21 Customs Agents of the Taxation (Cross Border Trade) Act 2018. This authorisation is applicable to all consignments arriving or departing from the UK. This Appointment applies with effect from the date of signature until revoked by the firm named below. The entity named below authorises UK Import Services Limited to delegate Customs clearance to sub agents as a direct Customs agent of the declarant in all dealings with HMRC where circumstances necessitate. If you have your own VAT Number and/or Deferment Accounts held with UK Customs, please complete the following: The entity named below authorises their representative, UK Import Services Ltd, to declare goods to HMRC using one or both of these numbers mentioned above.

Name / Electronic Signature (Mandatory field)

Dated (Mandatory field)