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It requests complete company details, licensing qualifier information, history and changes in ownership or corporate structure, volume and types of activity, service scope, participation in programs such as Remote Location Filing, and roles as Importer of Record or Ultimate Consignee. It also covers conflicts of interest, employee background and reporting practices, Powers of Attorney verification workflows, including processes for non-resident importers, and referrals involving unlicensed persons.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":20,"@type":76,"position":81},"https://docshare.wps.com/document/exam/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/broker-questionnaire/395881/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/broker-questionnaire/395881.png","ImageObject",300,407,{"name":92,"@type":93},"8796093062539","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-11","2026-09-26",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What information must the broker provide in Section 1?","Question",{"text":112,"@type":113},"Section 1 requests broker details including filer code, EIN, name of brokerage, license qualifier and local permit qualifier information, address, telephone, broker email address, and driver license information.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What types of changes must be reported under Section 2.2?",{"text":117,"@type":113},"Section 2.2 asks whether there were changes in ownership, licensed or permit qualifier, corporate structure, corporate officers, and business address or residential address, referencing 19 CFR 111.28 and 111.30.",{"name":119,"@type":110,"acceptedAnswer":120},"How are Powers of Attorney (POAs) obtained and validated in Section 3.1?",{"text":121,"@type":113},"Section 3.1 asks how POAs are obtained from clients, how the process is expedited for new clients, how POA information is validated, how POAs are handled for referred parties, and whether employee POA validations are reviewed.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},395881,1790963131,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":66,"doc_module":4,"category_id":19,"category_name":20,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":138,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":36,"preview_page_count":4},8796093062539,"U.S. Customs and Border Protection Broker Management Office  \nBROKER QUESTIONNAIRE  \nNote: Please complete this questionnaire in its entirety. In section 1, regarding your company’s information, if you notice anything that is not accurate, draw a single line across the incorrect information then provide the correct information with your initials.  \nThis completed questionnaire must be submitted to me with the requested documentationsas outlined on the last page, by Thursday, July 16, 2020.  \nPlease send the completed questionnaire and requested documents in pdf, via email to:  \n[linda.selga@cbp.dhs.gov](linda.selga@cbp.dhs.gov)  \nThe purpose of this questionnaire is to obtain information about the brokerage’s organizational structure and procedures related to U. S. Customs and Border Protection (CBP) transactions. The questionnaire is designed to give the CBP team a general understanding of the broker’s operations. Also to ensure that the Broker conduct his/her Brokerage business within 19CFR 111 guidelines.  \nSection 1: Company Information  \nBroker Information:  \nFiler Code:    EIN:   \nName of Brokerage:  .   \nLicense Qualifier:    \nAddress:    \nTelephone Number:   \nBroker Email Address:     \nName and Title of Local permit qualifier and/or License qualifier:  \n1.    \nDriver License Number:   \nName on the Driver License:   \n2.    \nDriver License Number:   \nName on the Driver License:   \nSection 2: Company Overview  \nSection 2.1: Company Information  \nHow long has company been in business?    \nHours of operation:    \nSection 2.2: Changes in Business- (19 CFR 111.28 and 111.30)  \nHave there been any changes in ownership of the company? YES ( ) NO ( )  \nHave there been any changes to the licensed qualifier and/or permit qualifier? YES ( ) NO ( ) Have any changes to the Corporate Structure occurred: YES ( ) NO ( ) N/A ( )  \nHave the Corporate Officers changed: YES ( ) NO ( )  \nHave any changes to the business address or residential address occurred: YES ( ) NO ( )  \nSection 2.3: Volume and Type of Activity  \nDoes the company specialize in a certain commodity or type of merchandise?  \nWhat Countries of Origin do the majority of your clients import from?    \nWhat entry types do you specialize in?   Number of entries filed per year.   \nWho are your largest clients?   \nWhat methods do you utilize to solicit for or receive new business?   \nDo you obtain a credit check on new or pending clients? YES ( ) NO ( )  \nExplain.    \nSection 2.4: Services Provided  \nDo you offer other services besides Customhouse Brokerage (i.e. trucking, freight forwarding, etc.)? YES ( ) NO ( )  \nDetails:    \nWhat percentage of the overall business is other than Brokerage activity?    \nDo you participate in the Remote Location Filing (RLF) Program? YES ( ) NO ( )  \nList RLF Ports, if any:    \nDo you act as Importer of Record (IOR) for your clients? YES ( ) NO ( )  \nHow often do you act as IOR?    \nDescribe the circumstances:   \nHow often do you act as an Ultimate Consignee?   Describe the circumstances:    \nSection 2.5: Conflict of Interest (19 CFR 111.31)  \nIs the qualifying licensee employed by another broker or does he/she serve as the licensee or permit qualifier for another broker or any other company? YES ( ) NO ( )  \nIf yes, explain:    \nDoes the licensed Broker have any interest (i.e. financially, etc.) in any other Customhouse Brokerage business or any other business entity (i.e. freight forwarding, warehousing, trucking, etc.)? YES ( ) NO ( )  \nIf yes, explain:    \nAre you aware if any of your employees have an interest (financially, etc.) in any Customhouse Brokerage business, freight forwarding, trucking, etc.? YES ( ) NO ( )  \nIf yes, explain:    \nSection 2.6: Employee Information-19 CFR 111.28 and 19 CFR 111.53  \nHave there been any changes to most recently submitted Employee list (employees newly hired or recently terminated)? YES ( ) NO ( )  \nWere these changes reported to CBP timely? YES ( ) NO ( )  \nIf no, give reason   Do you perform backgro","cbCairv2j6BkDZhQ","https://ap.wps.com/l/cbCairv2j6BkDZhQ","pdf",100592,16,"English","# Section 1: Company Information\n## Broker Information\n# Section 2: Company Overview\n## Section 2.1: Company Information\n## Section 2.2: Changes in Business- (19 CFR 111.28 and 111.30)\n## Section 2.3: Volume and Type of Activity\n## Section 2.4: Services Provided\n## Section 2.5: Conflict of Interest (19 CFR 111.31)\n## Section 2.6: Employee Information-19 CFR 111.28 and 19 CFR 111.53\n# Section 3: Powers of Attorney\n## Section 3.1: Verification of POAs\n## Section 3.2: Non-resident Importers\n# Section 4: Relations with Unlicensed Persons\n## Section 4.1: Referrals for Brokerage Business","[{\"question\":\"What information must the broker provide in Section 1?\",\"answer\":\"Section 1 requests broker details including filer code, EIN, name of brokerage, license qualifier and local permit qualifier information, address, telephone, broker email address, and driver license information.\"},{\"question\":\"What types of changes must be reported under Section 2.2?\",\"answer\":\"Section 2.2 asks whether there were changes in ownership, licensed or permit qualifier, corporate structure, corporate officers, and business address or residential address, referencing 19 CFR 111.28 and 111.30.\"},{\"question\":\"How are Powers of Attorney (POAs) obtained and validated in Section 3.1?\",\"answer\":\"Section 3.1 asks how POAs are obtained from clients, how the process is expedited for new clients, how POA information is validated, how POAs are handled for referred parties, and whether employee POA validations are reviewed.\"}]","BROKER QUESTIONNAIRE | PDF",1790425689]