DIRECT REPRESENTATION FORM

Hereby appoint B (names) CG Conex Ltd (EORI no.) GB109269212000 (iii)
to act on behalf of company name at A in the capacity of direct customs agent in accordance with Section 21
Customs Agents of the Taxation (Cross Border Trade) Act 2018. This authorisation is applicable to all
consignments arriving to, or from the UK.

This Appointment applies with effect from the date of signature until revoked by the firm named at A above.

The entity named at A named above authorises the Customs agent named at B to delegate Customs clearance to
sub agents where necessary in a Direct Representation capacity in all dealings with HMRC.

The entity named in A authorises their representative, the customs agent names at B, to declare goods to HMRC
using the below

Your instructions to us must include the following details to process the papers correctly.

• Your clients accounting details for customs payments, this involves the following:
  
  • Deferment number (if applicable) for duties, excise and/or VAT,
  • Notification to use CDS Immediate Payment or CDS Cash Account. We must be authorised to use either by the EORI number above (B),
  • PVA (Postponed VAT Accounting).
• P&R (Prohibition & Restrictions). Should the commodity code of the goods fall under P&R as per the UK Trade Tariff, you are to notify us of any specific licencing measures. If we are not informed, we will presume goods are not subject to these requirements, and waiver the P&R.

NOTE:
In accordance with Section 21 Customs Agents of the Taxation (Cross Border Trade) Act 2018, a direct customs
agent acts in the name of and on behalf of another person. In relation to import/export declarations, the
importer/exporter will be liable for any customs debt arising from the declaration.

NOTE: (i) Name of person signing, who must have authority to sign on behalf of the importer or exporter.
(ii) Legal name & EORI Trader Identification No. of importer or exporter.
(iii) Legal name & EORI Trader Identification No. of representative or agent.
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