Shri………………….of …………………..having been registered in the books of this office as a clerk of Shri/Savashri………………….of …………………..having been Authorized by him/them to transact business at the…………………….customs house on his/their behalf, is hereby permitted to do so for a period of ………………years with effect from ………………….19………or until the cancellation of the licence issued to his principal whichever is earlier.

Specimen signature of clerks……………….Agents………………….

										Customs Station 
										.......19.... 

                                                (Photo to be Supplied by the agent)