Pursuant to relevant provisions of “Regulations of the People‘s Republic of China Governing Customs Protection of Intellectual Property Rights”, I / We, _________________________________, citizen / legal entity of _____________, hereby authorize _____________________________ ( Address: ___________________________________) to represent me / us in Customs recordation and protection matters on intellectual property for my / our IPR _____________________________________ under registration certificate No. _________.
委托单位名称或委托人姓名:
Authorized by (Print or Type Name): _____________________________
委托单位印章或委托人签字:
Seal or Signature: _____________________________
委托日期:
Date of Authorization: _____________________________