Transcription of COMMONWEALTH OF PENNSYLVANIA AUTHORIZATION …
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COMMONWEALTH OF PENNSYLVANIA AUTHORIZATION …
AUTHORIZATION OF REPRESENTATIVECOMMONWEALTH OF PENNSYLVANIA COUNTY OF Mag. Dist. No:MDJ Name:Address: No:Case Filed:PURSUANT TO PA. NO. 207(B):Individual:I designate _____ to act as the authorized representative in the above-captioned :Name (Print):Signature:Partnership, Corporation or Similar Entity:I designate _____ to act as the authorized representative of _____ in the above-captioned :Name (Print):Signature:Authorized Representative Contact Information:Name:Address:City, State, Zip:Phone:I further certify that I have the authority to execute this form on behalf of the party and that I am: (check one)I,_____, do hereby verify, to the best of my knowledge, information and belief, that I have personal knowledge of the facts and circumstances of the above-captioned :Name of Authorized Representative (Print):the individual or sole proprietor that is the party.
Feb 24, 2021 · AUTHORIZATION OF REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF Mag. Dist. No: MDJ Name: Address: Telephone: _____ v. …
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