Transcription of Letter of Authorization Appointing a …
1 Letter of Authorization Appointing a representative in my Absence I, _____, appoint the following individual(s) to act as my duly appointed representative during the course of my relocation. This individual shall act in my interest and be granted the authority to act on my behalf. I understand and acknowledge that in Appointing this individual(s) to act as my agent, all decisions, directions and agreements made by this individual are binding upon me. ** IF you are designating a representative at Origin, please provide the following information: Individual s Name: _____ Contact Phone Number: _____ IF you are designating a representative at Destination, please provide the following information: Individual s Name: _____ Contact Phone Number: _____ By typing your name in the line provided below, you are providing your digital signature and Authorization for the above. Agreed and Acknowledged by: Customer s Name: _____
