我/我们_____________________________，是_______国的公民/法人，根据《中华人民共和国知识产权海关保护条例》，兹委托____________________________________________________(地址：________________________________________________________)代理__________________________(授权号：__________)的知识产权海关保护事宜。
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： _____________________________
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