Certification for Manifest Confidentiality Request Form

James J. Boyle & Co. is pleased to inform you that we provide this service to our clients for a nominal fee. If your company is interested in having JJB assist you with submitting a Certification for Manifest Confidentiality, please submit the form below.

We hereby request JJB’s Manifest Confidentiality Certification Service for one or both of the following: *

Import Manifest Confidentiality Certification

Export Manifest Confidentiality Certification

Which JJB Branch office you are receiving service from? *

List the company’s name and up to 10 permutations or variations of the company’s name that may be used on shipping documentation.
(Customs’ computer searches for the exact spelling of the name including punctuation. Customs will accept up to 10 name permutations and variations per IRS (EIN) number.) *

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IRS (EIN) Number (include all applicable branch suffixes) *

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Primary Address of the importer or consignee. *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Billing Address (if different from the Primary Address)

Address Line 2

City

State

Zip Code

Primary Contact First Name *

Last Name *

Job Title *

Phone Number *

Email Address *

Manifest Confidentiality Certification Service will be billed at a base rate of $150 per Import and/or Export Manifest Confidentiality Certification plus $25 for any additional company name variations and/or EINs and is payable upon receipt. JJB’s services are subject to our Terms and Conditions of Service.