Authorization Letter to Sign on Someone’s Behalf Form

Authorization Letter to Sign on Someone’s Behalf Form
Complete this form to authorize another individual to sign documents on your behalf. Please provide accurate information for both parties and specify the scope and duration of authorization.
Authorizing Party’s Full Name
First NameLast Name
Authorizing Party’s Email Address
example@example.com
Authorizing Party’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Signer’s Full Name
First NameLast Name
Authorized Signer’s Email Address
example@example.com
Authorized Signer’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Scope of Authorization (describe what the authorized signer is allowed to sign or do)
Documents or Transactions Covered
Effective Start Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Expiration/End Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: