Transcription of COMPANY LETTERHEAD/LOGO Current Date …
1 COMPANY letterhead /LOGOC urrent date ( valid for ONE YEAR)To Whom It May Concern:By my signature on this statement, I, _____, _____ authorize the Name (please print) Titlefollowing employees to represent, and sign building permit applications on my behalf, in Montgomery County, as the applicant, until this authorization is rescinded by me (in writing). Sincerely, _____ Original SignatureList of Authorized Representatives:_____ _____Authorized Representative s Original Signature Print Name_____ _____Authorized Representative s Original Signature Print Name_____ _____Authorized Representative s Original Signature Print Nam
