我/我們_____________________________，是_______國的公民/法人，根據《中華人民共和國知識產權海關保護條例》，茲委托____________________________________________________（地址：________________________________________________________）代理__________________________（授權號：__________）的知識產權海關保護事宜。
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. _________.
委托單位名稱或委托人姓名：
Authorized by （Print or Type Name）： _____________________________
委托單位印章或委托人簽字：
Seal or Signature： _____________________________
委托日期：
Date of Authorization： _____________________________
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. _________.
委托單位名稱或委托人姓名：
Authorized by （Print or Type Name）： _____________________________
委托單位印章或委托人簽字：
Seal or Signature： _____________________________
委托日期：
Date of Authorization： _____________________________