DEC Authority

Letter of Authority – Defence Export Controls only

I/ We (insert name below)

First

Last

Firearms License Number

In the state of Australia (QLD, VIC, NSW, WA, SA, NT)

give authority to Renee Wilson of Custom Brokers Pty Ltd (ABN 63 636 237 682) to act on my behalf in all matters relating to the export of my firearms, equipment, and ammunition to the upcoming trip to compete at (provide competition Details (Location, Country, Dates))

Phone

Email

Todays Date

Address

City

State/Province

Zip/Postal

Country

Signature

Clear