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AGRA-Services Brokerage Co., Inc.
221-20 147th Ave.
Jamaica, NY 11413

Phone: 718-527-0560
Fax: 718-723-8645

Customs Broker Limited Power Of Attorney

Please enter the following information. We will display a form with your information for you to print and fax.

Grantor's Name (Company Name):
Doing Business As (If Applicable):
Principal Place of Business:
The Grantor's business is organized under the laws of the state of:
The business is a:
General Partners (Partnerships only):
IRS Number: