P E Ł N O M O C N I C T W O(UPOWAŻNIENIE)

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Aneta Janik
9 lat temu
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1 ...dnia... (miejscowość) (place, date) P E Ł N O M O C N I C T W O(UPOWAŻNIENIE) (Power of Attorney) do działania w formie przedstawicielstwa bezpośredniego (to act on behalf of our company as a direct representative) Niniejszym na podstawie art. 5 ustęp 1 i 2 Rozporządzenia Rady EWG Nr 2913/92 z dnia r. ) ustanawiającego Wspólnotowy Kodeks Celny oraz art. 75,76, 77, 78 i 79 ustawy Prawo celne oraz 136 i 137 ustawy Ordynacja Podatkowa udzielam pełnomocnictwa firmie: DTA Sp. z o. o., ul. Karmelkowa 29, Wrocław wpisanej do rejestru przedsiębiorców pod nr KRS ; Regon ; NIP ; EORI PL wraz z zatrudnionymi pracownikami, wpisanymi na listę agentów celnych bez względu na rotacje kadrowe, do podejmowania na rzecz: (Pursuant to art. 5 (1) and (2) of the EEC Council Resolution no. 2913/92 of , establishing Community Customs Code and art. 75, 76, 77, 78 and 79 of the Customs Code Act, and art. 136 and 137 of the Tax Code I hereby authorize DTA Sp. z o.o., with the registered seat at Karmelkowa 29, Wrocław, KRS , Regon: , NIP: , EORI PL , and its employed certified customs brokers to represent our company) NIP: Regon: EORI: KRS (or other commercial register) ( nazwa, siedziba oraz numery rejestrowe osoby fizycznej lub prawnej udzielającej pełnomocnictwa) (name, address and registry data of the authorizing party) do a. działań przed organami celnymi celem spełnienia wszelkich czynności i formalności przewidzianych w ustawodawstwie celnym Unii Europejskiej (in the proceedings before the customs authorities regarding actions and formalities provided by the EU customs regulations) b. działań przed organami celnymi w sprawach dotyczących podatku VAT oraz podatku akcyzowego z tytułu importu towarów ( na podstawie art a Ustawy Ordynacja podatkowa tekst jednolity Dz. U , nr 8, poz. 60 z późniejszymi zmianami) (in the proceedings before the customs authorities in the VAT- and excise- related cases due to the import of commodities [pursuant to art. 137 (1a) of the Polish tax law, consolidated version JL no. 8, 2005, with later amendments] c. rejestracji/aktualizacji danych w systemie PDR, SISC (for data registration/ update in PDR, SISC system) związanych z dokonywaniem obrotu towarowego z zagranicą. (related to the international commercial turnover) Stosownie do art. 77 Ustawy Prawo Celne wyrażam zgodę na udzielenie dalszego upoważnienia. (Pursuant to art.77 of Polish Customs Code I hereby authorize DTA Sp. z o.o. to grant further power of attorney to other persons.) power_of_attorney_dta Strona 1/5

representative) Niniejszym na podstawie art. 5 ustęp 1 i 2 Rozporządzenia Rady EWG Nr 2913/92 z dnia 12.10.1992 r. ) ustanawiającego Wspólnotowy Kodeks Celny oraz art.

2 Niniejsze pełnomocnictwo ma charakter (wstawić symbol X): (This power of attorney is) a) jednorazowy (single) b) stały (permanent) c) terminowy do dnia(temporary, valid by):. Potwierdzam zapoznanie się z treścią i przyjecie do stosowania wymagań zawartych w załącznikach nr 1, nr 2 i nr 3 stanowiących integralną część niniejszego upoważnienia i oświadczam: - że informacje zawarte w upoważnieniu i w załączonych dokumentach są prawdziwe, -, że jestem świadomy odpowiedzialności karnej za złożenie fałszywego oświadczenia Upoważnienie sporządzono w dwóch jednobrzmiących egzemplarzach, po jednym dla każdej ze stron. (I hereby confirm the acknowledgement of the requirements referred to in attachments 1, 2 and 3, serving as the integral parts of this PoA, and declare that: - the information contained in the PoA and attached documents is correct and valid, - I am aware of the criminal liability in case of false statement) pieczęć firmowa i czytelny podpis upoważniającego (zgodnie ze sposobem reprezentacji firmy) Potwierdzenie przyjęcia pełnomocnictwa: (PoA received by)... (data i podpis agenta celnego działającego w imieniu DTA Sp. z o.o.) (date and signature of DTA customs broker) power_of_attorney_dta Strona 2/5

zawarte w upoważnieniu i w załączonych dokumentach są prawdziwe, -, że jestem świadomy odpowiedzialności karnej za złożenie fałszywego oświadczenia Upoważnienie sporządzono w dwóch jednobrzmiących

3 Attachment 1 to the PoA for DTA Sp. z o.o. A) Principal s data Chief Financial Officer: Name... ID no.... Telephone... Fax B) Bank and account number C) Competent tax office data D) Contact person: Name... Telephone... Fax... E) Import/ Export instructions please provide the receiving address for the following information: import; e.g. customs duty, customs declaration details .. export; e.g. IE529 release for export or IE599 export confirmation communications .. The authorized party, DTA sp. z o.o. with the registered seat in Wroclaw, ul. Karmelkowa26, hereby declares that the personal data provided shall be processed exclusively for the purpose of provision of customs and logistic services and possible claim settlement. You have the right to access the data and correct it as required. authorizing person official signature and stamp power_of_attorney_dta Strona 3/5

.. e-mail E) Import/ Export instructions please provide the receiving e-mail address for the following information: import; e.g. customs duty, customs declaration details e-mail.. export; e.g. IE529 release for export or IE599 export confirmation communications e-mail.

4 for DTA sp. z o.o. Attachment 2 to the PoA for DTA sp. z o.o. Authorizing and ordering services 2.1) I herby undertake to update all relevant documents and inform in writing of any changes of registry data (e.g. company seat, representation, PoA data, etc.) as well as of any actions taken by the company or third persons under the bankruptcy law within 7 days from the date of these changes or actions. 2.2) The Principal hereby declares that he is not subject to any judicial or administrative execution decisions or proceedings. All tax and duty debts are settled by the Principal in due time. 2.3) I hereby undertake to maintain due care in preparation and delivery of relevant documents required for each individual customs declaration. In particular: a. accurate translation of the commercial invoice to Polish (including the translator s legible signature and ID no.) b. complete documents and necessary information describing the shipment, in particular regarding the commission, (of purchase and sales), copyrights, license fees, and other factors affecting the goods customs value and tax basis, c. compliance of such parameters of the goods, as type, amount and weight with the provided documents, d. on-time completion of any recommendations, summons, decisions and orders of the customs authorities, issued in the course of proceedings, e. the Principal shall be liable for the compliance of the goods with the documents provided for the customs clearance. 2.4) I hereby undertake to provide as required by the customs authorities any additional information or documents necessary for correct customs clearance and relevant for the customs inspection. 2.5) In case of failure to provide the goods or documents required for the customs clearance within the set time-limit, I undertake to cover any warehouse, storage, return and handling expenses incurred in the course of assignment of customs-approved use. 2.6) In case of obtaining of the Binding Tariff Information, I undertake to provide DTA immediately with a relevant copy. 2.7) Aware of the criminal liability under the criminal law I hereby declare that the goods handed to DTA sp. z o.o. for the customs and logistic handling within the international commercial turnover: a) are not armaments as defined by the act of 29 Nov of the international turnover of goods, technologies and services of strategic importance for the national security, and for preservation of international peace and security (JL 2013 item 194) b) are not goods of strategic importance for the national security, as defined by the act of 29 Nov of the international turnover of goods, technologies and services of strategic importance for the national security, and for preservation of international peace and security (JL 2013 item 194). (for DTA sp. z o.o.) power_of_attorney_dta Strona 4/5

) as well as of any actions taken by the company or third persons under the bankruptcy law within 7 days from the date of these changes or actions. 2.

5 Attachment 3 to the PoA for DTA sp. z o.o. In case of failure to fulfill any of the above obligations the Principal shall bear all negative consequences resulting from this failure. 3.1) DTA Sp. shall not be liable for inadequate completion of service under this PoA, due to the reasons on the part of the Principal, and in particular due to the Principal s failure to fulfill his obligations referred to in Attachment 2. The above provision shall also be valid in case of use of incorrect goods tariff assignment due to the reasons on the part of the Principal (goods information, incorrect invoice translation). In such case the Principal shall be obliged to fulfill the customs decision in full. 3.2) In case of use of this PoA in the simplified customs procedure under the CCC, the Principal shall remain the payer of taxes, duties and possible interests. The Principal undertakes to settle all debts in question immediately on the receipt of the summons for payment from DTA or customs authorities. In case DTA covers the debt in question on behalf of the Principal, DTA is entitled to immediate repayment of the debt (upon the written notice) by the Principal. The remaining PoA attachments: The PoA shall be supplemented by the Principal by the following document copies: A. KRS or commercial register (with all additional documents, such as incorporation agreement for the partnerships), B. REGON statistical certificate, C. NIP tax certificate, VAT certificate, D. EORI number confirmation, E. PDR registry documents. (for DTA sp. z o.o.) power_of_attorney_dta Strona 5/5

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