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Schedule 1

(Regulations 3 and 13)

FORM 1

FORM OF APPLICATION FOR APPRENTICE PERMIT, CUSTOMS CLERK LICENCE OR CUSTOMS BROKER LICENCE

The Secretary

Customs Brokers & Customs Clerks Commission

c/o Customs & Excise

Castries

I, the undersigned do hereby apply for an Apprentice Permit/a Customs Clerk Licence/a Customs Broker Licence in accordance with Section 14(1) of the Customs Brokers and Customs Clerks Act.

PLEASE PRINT CLEARLY

Personal Information

Name ........................................ Declarant # ........................................

Date of Birth ........................................ Telephone # ........................................

Postal address ................................................ Work address

........................................................................................................................

Academic Qualifications (Attach additional sheet if necessary)
Subject	Level e.g. GCE/CXC/OTHER	Year

Customs related professional training (Attach additional sheet if necessary)
Course	Institution	Year

Employment information (if applicable)

Current Employer ................................................................................

Employer Postal address ................................................................................
.....................................................................................................................

Position held ................................................................................

Clients information (Attach additional sheet if necessary)
Name	Imp/Exp#

Customs offences committed in past two years (Attach additional sheet if necessary)
Offence	Fines or penalties	Year

Apprentice/Customs Clerk Undertaking and Declaration
I, undersigned Customs Broker/Employer do hereby affirm that I have agreed to recruit the herein mentioned person as an Apprentice/Customs Clerk and furhter declare that I shall be responsible for that person's supervision during the apprentice period in accordance with the provisions of the Customs Brokers and Clerks Act.
Licence No ........................................ Signature ........................................

Are you suffering from any mental or physical incapacity which can hinder your ability to perform the duties of a Customs clerk?
Yes £	No £	If yes provide details.

DECLARATION

I hereby declare that I am of full age and I have enclosed a certified Birth Certificate and a current Police Record. I further declare that the information contained in this document is true and correct.

Signed ........................................ Received ........................................
Signature and date Received Signature and date

You may be required to provide proof of any statement made above including copies of certificates and letters of authorisation. The Customs Brokers and Customs Clerks Association reserves the right to investigate any claims made above and any matters arising out of those claims.

FORM 2

FORM OF RENEWAL APPLICATION

CUSTOMS BROKERS & CUSTOMS CLERKS COMMISSION

Application for Renewal of Licence or Permit

No ........................................ Dated ........................................

The Secretary
Customs Brokers & Customs Clerks Commission
c/o Customs & Excise
Castries.

I, the undersigned do hereby apply for renewal of the Apprentice permit/Customs Clerk licence/Customs broker licence No .................................... dated ............................ and issued to ....................................................... in accordance with section 16(2) of the Customs Brokers and Customs Clerks Act.

I hereby declare that there has been no change in my status nor have there been any developments which can preclude the granting of a renewal.

Signed ........................................ Received ........................................
Signature and date Receiver's Signature and date