What happens if HS code is incorrect?

Incorrect HS codes can trigger duty reassessment, shipment holds, or penalties from U.S. Customs and Border Protection. Correct by filing a post-entry correction or protest under CBP procedures and retain supporting documentation to reduce liability and facilitate any claims against surety bonds.

Do I need a notary or RON for signatures?

Notarization requirements depend on the document and state. Many import applications do not require notarization, but powers of attorney and certain state filings may. Remote online notarization (RON) is permitted in most states; verify state rules and retain audio-video records as required.

Can this form be e-signed and retained electronically?

Yes, electronic signatures are legally valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA in most states when intent, consent, attribution, and record retention are satisfied; however exceptions like wills or certain court filings still require paper or in-person procedures.

Who can sign as authorized officer?

An authorized officer or designated agent with a valid power of attorney may sign. The application typically requires printed name, title, and contact information. Ensure the signer has corporate authority; inaccurate or unsigned attestations can create civil or criminal liability.

What supporting documents are commonly required?

Common attachments include invoices, packing lists, bills of lading, certificates of origin, importer of record documentation, relevant agency permits (FDA, EPA), power of attorney if broker files, and any insurance or bond certificates supporting duty payment.

How long must I retain signed records?

Retain signed applications and supporting records at least three years to satisfy IRS requirements (IRC §6501), six years where HIPAA applies (45 CFR §164.530(j)), and longer where agency or state law mandates; consult counsel for specific retention obligations.

Electronic Signature
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Distributor-Importer License Application

Distributor-Importer License Application

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DISTRIBUTOR-IMPORTER LICENSE APPLICATION

Recitals

WHEREAS, the Applicant seeks authorization to act as a distributor and importer of goods described in this application within the territorial jurisdiction set forth herein; and

WHEREAS, the Licensing Authority requires disclosure of business, operational, and compliance information to evaluate eligibility, ensure public safety, and enforce applicable statutes and regulations; and

WHEREAS, by submitting this application the Applicant certifies that all information provided is complete, true, and accurate and agrees to comply with the terms, conditions, and obligations established upon issuance of a Distributor-Importer License.

Applicant Information

Business Legal Name DBA / Trade Name

Federal Employer ID (FEIN):

Business Phone:

Principal Business Address Mailing Address (if different)

Business Details

Entity Type (select all that apply):

Corporation Limited Liability Company (LLC) Partnership Sole Proprietorship Other: Primary Contact Name

Contact Email:

Contact Title:

Importation & Distribution Operations

Countries of Origin for Imported Products:

Products and Categories to be Imported/Distributed Warehousing / Storage Locations

Anticipated Annual Import Volume (units):

Anticipated Annual Distribution Volume (units):

Scope of Work

Describe the specific scope of importation, distribution, and ancillary services to be performed under the requested license. Include methods of transport, warehousing procedures, quality control, and any subcontracting arrangements.

Payment Terms

License Fee Amount: $

Payment Schedule and Method

Late Fee for Overdue Payments: . The Applicant acknowledges that late fees accrue monthly on outstanding balances and that interest may compound as provided by applicable law.

Term and Termination

Proposed License Start Date: Proposed License End Date (if applicable):

Notice Period for Termination by Either Party: days. The Licensing Authority may suspend or revoke the license for material noncompliance, fraud, or conditions that present an imminent risk to public safety; the Applicant shall have the opportunity to cure where required by law.

Confidentiality

All non-public information provided with this application shall be treated as confidential to the extent permitted by law. The Applicant acknowledges that certain information may be subject to disclosure under applicable public records laws or in enforcement proceedings. The License, if issued, may require additional confidentiality protections as a condition of approval.

Compliance and Certifications

The Applicant certifies compliance with all applicable customs, import/export, transportation, safety, and product labeling statutes and regulations. The Applicant will maintain insurance coverage required for distribution and importation activities, including at a minimum commercial general liability and cargo insurance. No prior distributor or importer license held by the Applicant has been revoked within the past five years.

If any compliance checkbox above is unchecked, provide explanation:

Attachments Checklist

Articles of Incorporation / Organization or equivalent Operating Agreement / Partnership Agreement Proof of Insurance (policy declaration page) Facility diagram and storage plan Customs broker agreement (if applicable) Other Attachments (list)

Governing Law

This application, and any subsequent license issued in reliance upon this application, shall be governed by and construed in accordance with the laws of the state of without regard to conflict of laws principles.

Entire Agreement

The Applicant acknowledges that this application, together with any written terms, conditions, and rules attached to an issued license, constitutes the entire understanding between the Applicant and the Licensing Authority with respect to the subject matter hereof and supersedes all prior oral or written representations.

Declaration and Certification

By signing below, the Applicant certifies under penalty of perjury that the information contained in this application and accompanying attachments is true, complete, and accurate to the best of the Applicant's knowledge. The Applicant agrees to permit inspection of records and facilities by the Licensing Authority as necessary to verify compliance and understands that falsification may be grounds for denial or revocation of a license and for civil or criminal penalties.

Applicant (Printed Name):

By:

Date:

Licensing Authority (Printed Name):

By:

Date:

What the Distributor-Importer License Application Is

The Distributor-Importer License Application is a regulatory form used by businesses that intend to import goods into the United States for distribution or resale. It collects entity information, importer of record details, classification of goods, tariff and HS codes, point of entry, and compliance attestations required by federal and state agencies. Agencies use the application to verify business legitimacy, assess duties and taxes, and confirm adherence to customs, licensing, or controlled-substances controls where applicable. Completing the application accurately supports lawful importation and helps avoid delays at ports, fines, or shipment holds.

Why a Complete Application Matters

A correctly completed Distributor-Importer License Application establishes legal authority to import and distribute, clarifies tax and customs obligations, reduces clearance delays, and minimizes regulatory risk. It creates an auditable record for compliance with customs, tax, and controlled-import rules.

Who Typically Prepares This Application

Typical applicants include importers, licensed distributors, customs brokers, freight forwarders, and third-party logistics providers preparing documents for U.S. entry clearance.

Importers of record who will pay duties and control distribution channels.
Distributors acquiring international goods for resale to retailers or end customers.
Customs brokers and freight forwarders completing entry filings on behalf of clients.

Smaller sellers and new importers should verify licensing thresholds and state requirements before submitting to limit rework.

Core Sections to Expect on the Application

Core sections of the Distributor-Importer License Application define parties, import classifications, compliance attestations, duty arrangements, recordkeeping obligations, and signatures for responsible officers.

Applicant Information

Provide full legal entity name, DBA if applicable, EIN or TIN, business address, primary contact, and importer of record designation. Inaccuracies can delay customs clearance.

Goods Classification

List Harmonized System (HS) codes, detailed product descriptions, units, and country of origin. Precise HS codes determine correct tariff and duty rates applied on entry.

Importer of Record

Identify the importer of record with EIN/TIN, address, and authority to pay duties; indicate whether agent or principal status applies and include power of attorney when used.

Compliance Attestations

Declare compliance with customs, export controls, product-specific licensing (e.g., FDA, EPA), and controlled-substance rules. Attach permits or license numbers for regulated items.

Fees and Duties

Specify duty payment method, bonding information if using continuous bond or single-entry bond, and any prepayment arrangements. Include banking details for fiscal responsibilities.

Authorized Signature

Provide printed name, title, email, and handwritten or electronic signature of the authorized officer, plus date. Signatory attests to truthfulness and liability under penalty of law.

Required Data Elements at a Glance

Business Legal Name: Exact name as on EIN

EIN/TIN: Nine-digit federal taxpayer identification number

Importer of Record: Name and EIN/TIN for importer

HS Codes: Harmonized System six- to ten-digit codes

Country of Origin: Country where goods were manufactured

Point of Entry: Port code and expected arrival date

Consequences of Errors or Omissions

Customs Fines: Civil penalties and monetary fines

Cargo Seizure: Seizure or detention of goods

Duty Reassessment: Higher duties and retroactive bills

Bond Claims: Surety may be called to pay

Criminal Liability: False statements risk prosecution

Backup Withholding: TIN errors trigger 24% withholding

Common Preparation Pitfalls

Using incorrect or outdated HS codes that result in misclassification, delayed clearance, and retroactive duty assessments that increase total import cost.
Failing to list the correct importer of record or provide a valid power of attorney can prevent customs filings and cause carriers to refuse entry.
Omitting attachment of required permits for FDA, EPA, or other regulated products leads to rejection at entry, quarantine, and possible disposal of shipment.
Not retaining copies of signed applications and supporting documents undermines audit readiness and increases vulnerability to compliance penalties and bond claims.

Step-by-Step: Completing the Application

Complete the application sequentially, verify attachments, obtain authorized signatures, and submit to the issuing agency with required payment.

01

Prepare Documents: Gather EIN, invoices, permits, and HS code list
02

Complete Sections: Fill entity, importer, and goods details accurately
03

Attach Permits: Include any FDA, EPA, or commerce licenses
04

Sign & Submit: Authorized officer signs and files with payment

Where to Send the Completed Application

Submit the Distributor-Importer License Application to the relevant federal agency, state office, or port authority depending on product class and jurisdiction.

US Customs: File entry documents electronically via ACE or through a customs broker
Agency Licenses: Submit copies to FDA, EPA, ATF, or other regulator as required
State Filing: Some states require business licensing or registration prior to distribution
Port Authority: Provide arrival notice and bond paperwork to the selected port authority

Configuring an Online Submission Workflow

Configure the online application workflow to capture fields, attachments, signer roles, conditional logic, and submission routing.

Form Field Settings and Configuration Overview	Configuration and routing rules for each field
Signature Field Settings and Role	Require signer, set role, and date stamp
Attachment Upload Requirements and Validation	Force upload for permits and invoices
Conditional HS Code Display Rules	Show HS code fields when product is tariffed
Automated Routing Rules and Notifications	Auto-forward to customs broker or compliance team
Signer Authentication and Verification Levels	Use email, SMS, or KBA per risk level

Technical Requirements for eSubmission Platforms

For eSubmission, ensure the signing platform supports secure document storage, audit trails, and integrations with customs or ERP systems.

File Formats: PDF, DOCX, and machine-readable XML accepted
Integrations: Salesforce, NetSuite, Microsoft 365, Google Workspace
Authentication Options: Email, SMS OTP, KBA, or SSO

Typical Timelines and Processing Expectations

Typical filing and processing deadlines vary by agency; plan for license processing, bond issuance, and permit review timelines.

Application Submission Deadline and Payment Timing:

Depends on agency; allow 30–90 days

Customs Bond Issuance Timeframe and Approval:

Expect 1–2 weeks for standard surety bonds

Agency Permit Review Period and Decision:

Processing varies; FDA and EPA may take months

Customs Entry Clearance Timing at Port of Arrival:

Clearance can occur within 24–72 hours after arrival

Record Retention and Audit Availability Window:

Maintain records for minimum federal and state retention periods

eSignature Pricing and Feature Snapshot

Comparative pricing and feature availability for common eSignature solutions relevant to Distributor-Importer License Application eSubmission and secure recordkeeping.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes (Business Premium)	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Audit Trail	Yes	Yes	Yes	Yes	Yes

Frequently Asked Questions and Troubleshooting

[INTRO] Frequently asked questions and troubleshooting for the Distributor-Importer License Application, eSubmission, and common compliance issues are below.

Need help? Contact support

What happens if HS code is incorrect?
Incorrect HS codes can trigger duty reassessment, shipment holds, or penalties from U.S. Customs and Border Protection. Correct by filing a post-entry correction or protest under CBP procedures and retain supporting documentation to reduce liability and facilitate any claims against surety bonds.
Do I need a notary or RON for signatures?
Notarization requirements depend on the document and state. Many import applications do not require notarization, but powers of attorney and certain state filings may. Remote online notarization (RON) is permitted in most states; verify state rules and retain audio-video records as required.
Can this form be e-signed and retained electronically?
Yes, electronic signatures are legally valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA in most states when intent, consent, attribution, and record retention are satisfied; however exceptions like wills or certain court filings still require paper or in-person procedures.
Who can sign as authorized officer?
An authorized officer or designated agent with a valid power of attorney may sign. The application typically requires printed name, title, and contact information. Ensure the signer has corporate authority; inaccurate or unsigned attestations can create civil or criminal liability.
What supporting documents are commonly required?
Common attachments include invoices, packing lists, bills of lading, certificates of origin, importer of record documentation, relevant agency permits (FDA, EPA), power of attorney if broker files, and any insurance or bond certificates supporting duty payment.
How long must I retain signed records?
Retain signed applications and supporting records at least three years to satisfy IRS requirements (IRC §6501), six years where HIPAA applies (45 CFR §164.530(j)), and longer where agency or state law mandates; consult counsel for specific retention obligations.

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