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Short Form Power of Attorney/Invoicing/Return Instructions Form
For Entry of an Exhibit**Complete details and print. Sign printed copy where indicated and fax
TOLL FREE to (800) 956-8388**
 
1. POWER OF ATTORNEY and EXHIBITOR INFORMATION

COURTNEY AGENCIES LTD. of VANCOUVER is AUTHORIZED to CUSTOMS CLEAR FOR ME as REQUIRED and ARRANGE TRANSPORTATION as REQUIRED the SHIPMENT of GOODS DESCRIBED as FOLLOWS:

Name of Show and Booth Number:
Nature of Goods:
Value of Goods

The Invoice covering the shipment as now produced is the true and complete invoice of all the goods included in this shipment.

 

Signature of Exhibitor

 

 

   
Name Company representative at event:
 

Dated at ,  this Day of , 20
   
Name and address of Exhibitor:
(Fill in billing address below if Different): 		 
Company Name:
Address:
City:
Province/State:
Postal/Zip:
Name:
I hereby authorize the use of the following credit card for payment of services:
Visa Mastercard American Express
Cardholder Name:
Cardholder Number:
Expiry Date: 20
Cardholder's Signature:  
I hereby authorize payment of any outstanding duties, taxes and service charges for any E29B bond that remains un-cancelled (this is mandatory for goods transported by private vehicle).
2. Billing/Statement Address:  
Company Name:
Address:
City:
Province/State:
Postal/Zip:
Name:
Tel:
Fax:
3. Return Shipment Information  
After show, please RETURN Shipment to:  
Company Name:
Address:
City:
Province/State:
Postal/Zip:
Federal Tax Identification Number:
(required for US Customs)
Name:
Tel:
Fax:
Preferred Carrier:
Acct #
Required by: (Date)

Courtney Agencies Ltd.
Customs Brokers/Freight Forwarders
Phone: (604) 684-7505/Fax: (604) 683-7004
Toll Free Phone: 1-877-786-4970
Toll Free Fax: 1-800-956-8388